ACUTE-PANCREATITIS IN MARROW TRANSPLANT PATIENTS - PREVALENCE AT AUTOPSY AND RISK FACTOR-ANALYSIS

Pancreatitis has been described as an infrequent complication of marro w transplantation, This study investigated the prevalence of pancreati tis at autopsy in marrow transplant patients and determined risk facto rs for its development, We reviewed consecutive autopsy reports from 1 991 to 1993. Medical records and laboratory reports were reviewed for analysis of clinical variables, Autopsy findings and clinical variable s were correlated with the autopsy diagnosis of pancreatitis, Pancreat itis was found in 51 of 184 (28%) patients at autopsy, Of those with p ancreatitis, 35% had abdominal pain, 10% had measurements of serum pan creatic enzymes, and 20% had abdominal imaging studies in the week pri or to death, By univariable analysis, risk factors associated with dev elopment of pancreatitis included clinical grades 3 and 4 GVHD, GVHD a t autopsy, liver GVHD at autopsy, major infection at autopsy, and incr easing days of survival, By multivariable analysis, independent risk f actors for its development included any GVHD at autopsy, increasing le ngth of survival after transplantation, and major infection at autopsy , We conclude that pancreatitis is a common but often subclinical comp lication of marrow transplantation, Its development may be associated with a high prevalence of biliary sludge and prolonged treatment of GV HD with cyclosporine and prednisone.