Two patients with non-Hodgkin’s lymphoma (NHL) suffered from hematemesis due to exfoliative esophagitis early after autologous
peripheral blood stem cell transplantation (PBSCT). The chemotherapy regimens used for these 2 patients were the same and
consisted of high-dose ranimustine, carboplatin, etoposide, and cyclophosphamide (MCVC regimen), which have been widely used
in autologous PBSCT for NHL in Japan. Esophageal bleeding in both patients was stopped by conservative treatment without any
special endoscopic manipulations. Gastrointestinal bleeding after hematopoietic stem cell transplantation is usually caused
by viral infections, graft-versus-host disease, or conditioning chemo-radiotherapy. Although severe esophagitis is common
in patients receiving stem cell transplantation, the exfoliative form detected by endoscopic examination has not been reported.
We conclude that high-dose chemotherapy and frequent vomiting during treatment are risk factors for lower-esophageal bleeding
in these cases.
Key words Exfoliative esophagitis - Peripheral blood stem cell transplantation - Gastrointestinal bleeding - High-dose etoposide