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01-02-2018 | Original Article

Histologic analysis has a prognostical value in colorectal biopsies assessed for suspicion of graft-versus-host disease

Authors: Fanny Sauvestre, Geneviève Belleannée, Claire Bréal, Catherine Mohr, Harold IpKan Fong, Sébastien Cossin, Reza Tabrizi, Noël Milpied, Stéphane Vigouroux, Jean-François Goussot, Marion Marty

Published in: Virchows Archiv | Issue 2/2018

Abstract

Gastrointestinal (GI) graft-versus-host-disease (GVHD) is a common and severe complication of allogeneic hematopoietic stem cell transplantation, but clinical and histological features are unspecific. The aim of this study was to correlate the histological GI GVHD grade with the clinical outcomes. In a retrospective study of 112 patients with clinically suspected GI GVHD, colonic biopsies were reviewed by three pathologists without knowledge of the corresponding clinical data and classified in four scores, according to the NIH Consensus Project recommendations: no GVHD, possible, probable, and unequivocal GVHD. At the end of the study, the histological and clinical data were confronted with the following results: clinical diagnosis of GI GVHD was established for 70 patients (62.5%) and histological scores correlated well with the clinical diagnosis (p < 0.001) and particularly with the prognosis (p < 0.05).When severe lesions were observed, the 1 year overall survival declined to 9%. None of the features reported in the literature to support GVHD diagnosis, eosinophil count, endocrine cells aggregate, immunohistochemical analysis (cytomegalovirus, CD123, chromogranin), did not help us for diagnosis. So routine histopathology alone without immunohistochemistry is a strong and reproducible tool to diagnose GI GVHD with the help of clinical and biological information, and most importantly, histological grading proved to be a powerful prognostic value.

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Title: Histologic analysis has a prognostical value in colorectal biopsies assessed for suspicion of graft-versus-host disease
Authors: Fanny Sauvestre
Geneviève Belleannée
Claire Bréal
Catherine Mohr
Harold IpKan Fong
Sébastien Cossin
Reza Tabrizi
Noël Milpied
Stéphane Vigouroux
Jean-François Goussot
Marion Marty
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: Virchows Archiv / Issue 2/2018
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-017-2272-2

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Histologic analysis has a prognostical value in colorectal biopsies assessed for suspicion of graft-versus-host disease

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