Format

Send to

Choose Destination
United European Gastroenterol J. 2014 Jun;2(3):206-15. doi: 10.1177/2050640614529283.

Early detection of acute graft-versus-host disease by wireless capsule endoscopy and probe-based confocal laser endomicroscopy: results of a pilot study.

Author information

1
Institut des Maladies de l'Appareil Digestif, CHU and Université de Nantes, Nantes, France ; INSERM UMR 913, Université de Nantes, Nantes, France.
2
Institut des Maladies de l'Appareil Digestif, CHU and Université de Nantes, Nantes, France.
3
Service d'Hématologie Clinique, CHU and Université de Nantes, Nantes, France ; CRNCA, UMR 892INSERM - 6299 CNRS, Nantes, France.
4
Service d'Hématologie Clinique, CHU and Université de Nantes, Nantes, France.
5
CHU de Nantes, Laboratoire d'Anatomie-Pathologie, Nantes, France.
6
Service d'Hématologie Clinique, CHU and Université de Nantes, Nantes, France ; CRNCA, UMR 892INSERM - 6299 CNRS, Nantes, France ; Centre d'Investigation Clinique en Cancérologie (CI2C), Nantes, France.

Abstract

OBJECTIVE:

Acute gastrointestinal graft-versus-host disease (GI-GVHD) is usually diagnosed using endoscopic examinations and biopsies for conventional histology. The aim of this pilot study was to determine whether mini-invasive techniques such as probe-based confocal laser endomicroscopy (pCLE) combined with wireless capsule endoscopy (WCE) could detect early lesions of GI-GVHD prior to symptoms.

DESIGN:

Fifteen patients undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT) were prospectively examined with a small bowel WCE, duodenal and colorectal pCLE, and standard biopsies. Per study protocol, all these examinations were scheduled between day 21 and day 28 after allo-HSCT, independently of the presence or absence of digestive symptoms.

RESULTS:

During follow up, eight patients developed acute GI-GVHD. Sensitivity of WCE, pCLE, and histology were 50, 87.5, and 50%, respectively. Specificity of WCE, pCLE, and histology were 80, 71.5, and 80%, respectively. We showed a positive correlation between the Glücksberg scoring system and WCE (rho = 0.543, p = 0.036) and pCLE (rho = 0.727, p = 0.002) but not with standard histology (rho = 0.481, p = 0.069).

CONCLUSIONS:

The results from this pilot study suggest that novel methods such as pCLE and WCE could be part of a mini-invasive algorithm for early detection of GI-GVHD.

KEYWORDS:

Early diagnosis; graft-versus-host disease; novel imaging techniques; probe-based confocal laser endomicroscopy; wireless capsule endoscopy

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center