Hepatitic variant of graft-versus-host disease after donor lymphocyte infusion

Görgün Akpek, John K. Boitnott, Linda A Lee, Jason P. Hallick, Michael Torbenson, David A. Jacobsohn, Sally Arai, Viki Anders, Georgia Boyce Vogelsang

Research output: Contribution to journalArticle

Abstract

Graft-versus-host disease (GVHD) of the liver is characterized by bile duct damage and portal lymphocytic infiltrate. We report acute hepatitislike presentation of GVHD after donor lymphocyte infusion (DLI). Between April 1998 and September 2001, 73 patients received 94 DLI treatments. Liver GVHD developed after DLI in 22 (30%) patients whose median age was 43 years (range, 21 to 61 years). Onset of liver dysfunction was at 35 days (range, 11 to 406 days) after DLI. Fifteen patients underwent liver biopsy, and the diagnosis of liver GVHD was confirmed in 13 (87%) patients. After viral hepatitis and recent drug exposure were excluded, 11 (50%) patients were given a diagnosis of a hepatitic variant of GVHD based on histologic evidence of lobular hepatitis (n = 5), elevation of maximum serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) level more than 10 times the upper normal limit (n = 9), or both. There was a significant difference in maximum ALT (P = .002) and AST (P = .01) level between the hepatitic-variant and classical GVHD groups. GVHD progressed in 14 (64%) patients, and 10 patients died after a median follow-up of 221 days (range, 31-1284 days). These observations suggest that GVHD that occurs after DLI may have distinct clinical features. Hepatiticvariant GVHD should be considered in the differential diagnosis in DLI recipients with unexplained hepatitis.

Original languageEnglish (US)
Pages (from-to)3903-3907
Number of pages5
JournalBlood
Volume100
Issue number12
DOIs
StatePublished - Dec 1 2002

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Lymphocytes
Graft vs Host Disease
Grafts
Tissue Donors
Liver
Hepatitis
Aspartate Aminotransferases
Alanine Transaminase
Biopsy
Bile Ducts
Ducts
Liver Diseases
Differential Diagnosis

ASJC Scopus subject areas

  • Hematology

Cite this

Akpek, G., Boitnott, J. K., Lee, L. A., Hallick, J. P., Torbenson, M., Jacobsohn, D. A., ... Vogelsang, G. B. (2002). Hepatitic variant of graft-versus-host disease after donor lymphocyte infusion. Blood, 100(12), 3903-3907. https://doi.org/10.1182/blood-2002-03-0857

Hepatitic variant of graft-versus-host disease after donor lymphocyte infusion. / Akpek, Görgün; Boitnott, John K.; Lee, Linda A; Hallick, Jason P.; Torbenson, Michael; Jacobsohn, David A.; Arai, Sally; Anders, Viki; Vogelsang, Georgia Boyce.

In: Blood, Vol. 100, No. 12, 01.12.2002, p. 3903-3907.

Research output: Contribution to journalArticle

Akpek, G, Boitnott, JK, Lee, LA, Hallick, JP, Torbenson, M, Jacobsohn, DA, Arai, S, Anders, V & Vogelsang, GB 2002, 'Hepatitic variant of graft-versus-host disease after donor lymphocyte infusion', Blood, vol. 100, no. 12, pp. 3903-3907. https://doi.org/10.1182/blood-2002-03-0857
Akpek G, Boitnott JK, Lee LA, Hallick JP, Torbenson M, Jacobsohn DA et al. Hepatitic variant of graft-versus-host disease after donor lymphocyte infusion. Blood. 2002 Dec 1;100(12):3903-3907. https://doi.org/10.1182/blood-2002-03-0857
Akpek, Görgün ; Boitnott, John K. ; Lee, Linda A ; Hallick, Jason P. ; Torbenson, Michael ; Jacobsohn, David A. ; Arai, Sally ; Anders, Viki ; Vogelsang, Georgia Boyce. / Hepatitic variant of graft-versus-host disease after donor lymphocyte infusion. In: Blood. 2002 ; Vol. 100, No. 12. pp. 3903-3907.
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