Origin 8 cutler cb
7 patients underwent abdominal imaging during their evaluation, 6 had colonic involvement (3 with pancolitis). Patients reported watery, non-bloody diarrhea, commonly associated with weight loss. Median time to onset of CCS was 131 days after CB-SCT (range, 88–314). The 1-year cumulative probability of CCS was 0.159.
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Median follow up was 452 days (range, 1–2409).Įleven (10.6%) patients met criteria for CCS an additional patient had relapsing antibiotic-responsive diarrhea compatible with CCS, but was not biopsied and not included in the analysis. GVHD prophylaxis with sirolimus and tacrolimus was used in 69 patients, cyclosporine and mycophenolate mofetil in 17, and other combinations in the rest of the cohort. 72 underwent reduced-intensity conditioning, most commonly with fludarabine, melphalan, and thymoglobulin 32 underwent myeloablative conditioning with cyclophosphamide, fludarabine, total-body irradiation or other agents. Cord colitis syndrome (CCS) was defined as a persistent diarrheal illness in a CB-SCT recipient not due to GVHD, cytomegalovirus, Clostridium difficile or other identifiable etiology on extensive microbiologic and pathologic examination, with histopathological evidence of colitis, and who responded to empirical antibacterial treatment.ġ04 patients underwent CB-SCT during the study period 101 were double cord recipients. Demographic, CB-SCT, and diarrheal illness characteristics, and gastrointestinal pathology were analyzed. Charts were reviewed in detail for all episodes of diarrheal illness after engraftment.
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We studied the entire CB-SCT cohort at our center from 3/2003 through 3/2010. The clinical characteristics and epidemiology of this gastrointestinal syndrome have not been previously described.
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After umbilical cord blood transplantation (CB-SCT), we have observed a new syndrome of culture-negative antibiotic-responsive diarrhea, with pathologic findings on biopsy suggestive of an infectious/inflammatory colitis, but distinct from graft-versus-host disease (GVHD).