PET assessment of acute gastrointestinal graft versus host disease.
Ashleigh P ScottAndrea S HendenGlen A KennedySiok-Keen TeyPublished in: Bone marrow transplantation (2023)
Acute gastrointestinal graft versus host disease (GI-GVHD) is a common complication following allogeneic haematopoietic cell transplantation (HCT), and is characterised by severe morbidity, frequent treatment-refractoriness, and high mortality. Early, accurate identification of GI-GVHD could allow for therapeutic interventions to ameliorate its severity, improve response rates and survival; however, standard endoscopic biopsy is inadequately informative in terms of diagnostic sensitivity or outcome prediction. In an era where rapid technological and laboratory advances have dramatically expanded our understanding of GI-GVHD biology and potential therapeutic targets, there is substantial scope for novel investigations that can precisely guide GI-GVHD management. In particular, the combination of tissue-based biomarker assessment (plasma cytokines, faecal microbiome) and molecular imaging by positron emission tomography (PET) offers the potential for non-invasive, real-time in vivo assessment of donor:recipient immune activity within the GI tract for GI-GVHD prediction or diagnosis. In this article, we review the evidence regarding GI-GVHD diagnosis, and examine the potential roles and translational opportunities posed by these novel diagnostic tools, with a focus on the evolving role of PET.
Keyphrases
- positron emission tomography
- computed tomography
- allogeneic hematopoietic stem cell transplantation
- pet ct
- pet imaging
- liver failure
- acute lymphoblastic leukemia
- drug induced
- ultrasound guided
- respiratory failure
- cell therapy
- single cell
- bone marrow
- stem cells
- physical activity
- early onset
- mass spectrometry
- climate change
- mesenchymal stem cells
- cardiovascular events
- intensive care unit
- smoking cessation
- risk assessment
- extracorporeal membrane oxygenation
- replacement therapy
- hematopoietic stem cell