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Post-Transplant Events

Prospective evaluation of gut mucosal barrier injury following various myeloablative regimens for haematopoietic stem cell transplant

Bone Marrow Transplantation volume 35, pages 707–711 (2005)Cite this article

Summary:

We determined gut mucosal barrier injury (MBI) among 129 recipients of an allogeneic or autologous haematopoietic stem cell transplant (HSCT) who had been given different myeloablative regimens by measuring integrity using the lactulose/rhamnose (RHA) ratio and absorption using the ratios of rhamnose/3-O-methylglucose and xylose/3-O-methylglucose. Regimens that did not contain idarubicin induced oral mucositis and disturbed gut integrity and absorption earlier than did those containing the anthracycline. By contrast, regimens containing idarubicin induced more severe and prolonged oral and gut MBI. Gut integrity and absorption of most patients were still abnormal at discharge from hospital. These results confirm that the integrity and absorptive capacity of the gut is affected adversely by myeloablative regimens in general, although only two patterns of mucosal injury emerged depending on whether or not idarubicin was used.

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References

  1. Parulekar W, Mackenzie R, Bjarnason G, Jordan RC . Scoring oral mucositis. Oral Oncol 1998; 34: 63–71.

    Article  CAS  Google Scholar 

  2. Wardley AM, Jayson GC, Swindell R et al. Prospective evaluation of oral mucositis in patients receiving myeloablative conditioning regimens and haematopoietic progenitor rescue. Br J Haematol 2000; 110: 299.

    Article  Google Scholar 

  3. Rapoport AP, Miller Watelet LF, Linder T et al. Analysis of factors that correlate with mucositis in recipients of autologous and allogeneic stem-cell transplants. J Clin Oncol 1999; 17: 2446–2453.

    Article  CAS  Google Scholar 

  4. Blijlevens NMA, van't Land B, Donnelly JP et al. Measuring mucosal damage induced by cytotoxic therapy. Support Care Cancer 2004; 12: 227–233.

    Article  CAS  Google Scholar 

  5. Schaap N, Schattenberg A, Bar B et al. Outcome of transplantation for standard-risk leukaemia with grafts depleted of lymphocytes after conditioning with an intensified regimen. Br J Haematol 1997; 98: 750–759.

    Article  CAS  Google Scholar 

  6. Muus P, Donnelly P, Schattenberg A et al. Idarubicin-related side effects in recipients of T-cell-depleted allogeneic bone marrow transplants are schedule dependent. Semin Oncol 1993; 20 (Suppl. 8): 47–52.

    CAS  Google Scholar 

  7. Donnelly JP, Muus P, Schattenberg A et al. A scheme for daily monitoring of oral mucositis in allogeneic BMT recipients. Bone Marrow Transplant 1992; 9: 409–413.

    CAS  Google Scholar 

  8. Jansen G, Muskiet FAJ, Schierbeek H et al. Capillary gas chromatographic profiling of urinary, plasma and erythrocyte sugars and polyols as their trimethylsilyl derivates, preceded by a simple and rapid prepurification method. Clin Chim Acta 1986; 157: 277–294.

    Article  CAS  Google Scholar 

  9. Johnston JD, Harvey CJ, Menzies IS, Treacher DF . Gastrointestinal permeability and absorptive capacity in sepsis. Crit Care Med 1996; 24: 1144–1149.

    Article  CAS  Google Scholar 

  10. Lim SG, Menzies IS, Lee CA et al. Intestinal permeability and function in patients infected with human immunodeficiency virus: a comparison with coeliac disease. Scand J Gastroenterol 1993; 28: 573–580.

    Article  CAS  Google Scholar 

  11. Keefe DM, Cummins AG, Dale BM et al. Effect of high-dose chemotherapy on intestinal permeability in humans. Clin Sci Colch 1997; 92: 385–389.

    Article  CAS  Google Scholar 

  12. Ijiri K, Potten CS . Response of intestinal cells of differing topographical and hierarchical status to ten cytotoxic drugs and five sources of radiation. Br J Cancer 1983; 47: 175–185.

    Article  CAS  Google Scholar 

  13. Keefe DMK, Brealey J, Goland GJ, Cummins AG . Chemotherapy for cancer causes apoptosis that precedes hypoplasia in crypts of the small intestine in humans. Gut 2000; 47: 632–637.

    Article  CAS  Google Scholar 

  14. Cummins AG, Thompson FM, Butler RN et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease. Clin Sci 2001; 100: 379–386.

    Article  CAS  Google Scholar 

  15. Verburg M, Renes IB, van Nispen DJPM et al. Specific responses in rat small intestinal epithelial mRNA expression and protein levels during chemotherapeutic damage and regeneration. J Histochem Cytochem 2002; 50: 1525–1536.

    Article  CAS  Google Scholar 

  16. Beck PL, Wong JF, Li Y et al. Chemotherapy- and radiotherapy-induced intestinal damage is regulated by intestinal trefoil factor. Gastroenterology 2004; 126: 796–808.

    Article  CAS  Google Scholar 

  17. Fegan C, Poynton CH, Whittaker JA . The gut mucosal barrier in bone marrow transplantation. Bone Marrow Transplant 1990; 5: 373–377.

    CAS  Google Scholar 

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Acknowledgements

We like to thank M Balvers and Bea van't Land for technical assistance.

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Authors and Affiliations

  1. Department of Haematology, University Medical Centre, St Radboud, Nijmegen, The Netherlands

    N M A Blijlevens, J P Donnelly & B E de Pauw

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  1. N M A Blijlevens
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  2. J P Donnelly
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  3. B E de Pauw
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Correspondence to N M A Blijlevens.

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Blijlevens, N., Donnelly, J. & de Pauw, B. Prospective evaluation of gut mucosal barrier injury following various myeloablative regimens for haematopoietic stem cell transplant. Bone Marrow Transplant 35, 707–711 (2005). https://doi.org/10.1038/sj.bmt.1704863

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