Clinical relevance of acute pancreatitis in allogeneic hemopoietic stem cell (bone marrow or peripheral blood) transplants

This study investigated the clinical relevance of acute pancreatitis in all ogeneic hemopoietic stem cell (bone marrow or peripheral blood) transplants (BMT). We studied 26 patients undergoing BMT, The preparative regimen was busulfan and cyclophosphamide in 17 patients and total body irradiation and cyclophosphamide in 9 patients. Graft-versus-host disease (GVHD) prophylax is consisted of cyclosporin A and short-term methotrexate in all 26 patient s. The pancreas was studied using amylase and lipase serum levels, abdomina l contrast-enhanced tomography, and/or ultrasound. Clinical and laboratory signs of acute pancreatitis were found in two patients with acute hepatoint estinal GVHD, and in one patient with acute hepatic GVHD and cytomegaloviru s infection. This patient died of multiorgan failure, with interstitial acu te pancreatitis at autopsy; the other two patients recovered with general s upportive care and GVHD therapy. We suggest that in the patients with compl ications after BMT, particularly acute hepatic/hepatointestinal GVIID, and cytomegalovirus infection, the possibility of acute pancreatitis should be considered.