Use of Octreotide in the Management of Severe Duodenal Bleeding after Unrelated-Donor Bone Marrow Transplantation

Ohashi, Kazuteru; Sanaka, Masaki; Tanaka, Yuji; Okuyama, Yoshiki; Hiruma, Kiyoshi; Akiyama, Hideki; Sakamaki, Hisashi

doi:10.1007/bf02983391

Cited by 5 publications

(1 citation statement)

References 7 publications

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“…The mainstay of therapy for acute GVHD-related haemorrhage include supportive therapy to correct thrombocytopenia and coagulopathy, acid suppression and treatment of GVHD 158 . Continuous infusion of octreotide has been studied for the treatment of GVHD-related gastrointestinal bleeding, but its efficacy is lost when the drug is discontinued 172 . In the setting of ongoing bleeding that cannot be managed with conservative approaches, cases of successful arterial embolization have been reported 173 .…”

Section: Managementmentioning

confidence: 99%

Acute graft-versus-host disease of the gut: considerations for the gastroenterologist

Naymagon

Wong

et al. 2017

Nat Rev Gastroenterol Hepatol

118

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Haematopoietic stem cell transplantation (HSCT) is central to the management of many haematological disorders. A frequent complication of HSCT is acute graft-versus-host disease (GVHD), a condition in which immune cells from the donor attack healthy recipient tissues. The gastrointestinal system is among the most common sites affected by acute GVHD, and severe manifestations of acute GVHD of the gut portends a poor prognosis in patients after HSCT. Acute GVHD of the gastrointestinal tract presents both diagnostic and therapeutic challenges. Although the clinical manifestations are nonspecific and overlap with those of infection and drug toxicity, diagnosis is ultimately based on clinical criteria. As reliable serum biomarkers have not yet been validated outside of clinical trials, endoscopic and histopathological evaluation continue to be utilized in diagnosis. Once a diagnosis of gastrointestinal acute GVHD is established, therapy with systemic corticosteroids is typically initiated, and non-responders can be treated with a wide range of second-line therapies. In addition to treating the underlying disease, the management of complications including profuse diarrhoea, severe malnutrition and gastrointestinal bleeding is paramount. In this Review, we discuss strategies for the diagnosis and management of acute GVHD of the gastrointestinal tract as they pertain to the practising gastroenterologist.

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Section: Managementmentioning

confidence: 99%