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Cohort studyJournal of gastrointestinal and liver diseases : JGLD · 2026

Optimizing Diagnostic Precision: Patient Selection and Diagnostic Endoscopy in Gastrointestinal Graft-Versus-Host Disease after Allogeneic Bone Marrow Transplant.

Caroline Olson, Luke Tupper, Paul Travers … Maoyin Pang

HematologyCohort study

Flexible sigmoidoscopy is associated with higher odds of diagnosing gastrointestinal GvHD.

Optimizing Diagnostic Precision: Patient Selection and Diagnostic Endoscopy in Gastrointestinal Graft-Versus-Host Disease after Allogeneic Bone Marrow Transplant.

Caroline Olson et al. · Journal of gastrointestinal and liver diseases : JGLD · 2026

Background

Allogeneic hematopoietic stem cell transplant is standard treatment for many hematologic diseases and malignancies.

Methods

We performed a retrospective study of patients who underwent hematopoietic stem cell transplant and subsequent endoscopy for gastrointestinal symptoms.

n = 527 patients

OR 3.95

Results

flexible sigmoidoscopy makes it almost 4 times more likely to find gastrointestinal GvHD

n = 527 patients

More results

Of 527 patients, 242 (45.9%) had gastrointestinal GvHD.

Gastrointestinal GvHD was more likely to be found in patients with endoscopy findings of edema/erythema, friable mucosa, or colitis.

The only significant presenting symptom was diarrhea (56.6%; OR=1.79; p=0.001).

More results

The odds ratio was lower with presenting symptoms of dysphagia (5.4%; OR=0.3; p<0.001) and reflux (2.1%; OR=0.3; p=0.017).

“

Conclusion

Based on our results, both upper and lower endoscopy should be pursued regardless of presenting symptoms, and biopsies should be obtained regardless of endoscopy findings.

Post

Optimizing Diagnostic Precision: Patient Selection and Diagnostic Endoscopy in Gastrointestinal Graft-Versus-Host Disease after Allogeneic Bone Marrow Transplant.

Flexible sigmoidoscopy is associated with higher odds of diagnosing gastrointestinal GvHD.

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