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A 29-yr-old woman developed severe, progressive cholestasis 5 months after allogeneic bone marrow transplantation. Extrahepatic graft-versus-host diseases (GVHD) was absent. Skin biopsy was equivocal 2 months after transplant, rash was absent during the period of cholestasis, and cholangiographic abnormalities were absent. Liver biopsy 7.5 months posttransplant revealed chronic hepatic GVHD. Cholestasis dramatically resolved with high dose corticosteroid therapy. Chronic hepatic GVHD occurs in the absence of overt extraintestinal GVHD and responds promptly to therapy. This underscores the importance of aggressive diagnostic evaluation of posttransplant cholestasis. [ABSTRACT FROM AUTHOR]

The metabolic effects of intravenous cyclosporine on lipids and lipoproteins were studied in 29 allogeneic bone marrow recipients compared with 13 autologous bone marrow patients not requiring cyclosporine therapy. Patients were monitored continuously from 5 days prior to 27 days following transplantation; cyclosporine treatment was initiated 4 days before transplantation. Fasting lipid and lipoprotein levels were measured in serial blood samples throughout the study period. Nutritional supplementation, conditioning regimens and concomitant medications were not significantly different between groups. Furthermore, no significant differences in age, weight, lipid, or lipoprotein levels were found at baseline between the patient groups. Cholesterol, triglyceride, low-density lipoprotein cholesterol, and very low-density lipoprotein cholesterol levels remained unchanged in autologous patients. As compared with baseline values, plasma total cholesterol increased by an average of 26 percent in allogeneic transplantation patients receiving cyclosporine. Similarly, the ratio of low-density lipoprotein to high-density lipoprotein cholesterol was fourfold greater in those patients treated with cyclosporine compared to the autologous group. We conclude that cyclosporine appears to elevate cholesterol levels. Neither acute graft vs host disease nor changes in hepatic function could explain the differences in plasma cholesterol levels between groups. [ABSTRACT FROM AUTHOR]

This study was designed to evaluate the accuracy of the Oncology Patient Information Systems (OPIS) database for patients with breast cancer and lymphoma. We conducted a detailed individual patient chart review of patients with lymphoma or breast cancer who were seen in consultation by an oncologist between July 1991 and June 1995. Information extracted directly from the patients' clinic charts was compared with information captured in the OPIS database with respect to demographics, staging, histological diagnosis, treatment, relapse status, date of relapse and survival. OPIS database failed to capture 14.4% and 23.4% of lymphoma and breast cancer patients seen over the four-year period. When compared to the clinic charts there were differences in staging in 31.5% and 8.1%, relapse status in 27.6% and 7.2%, and date of relapse in 56.4% and 14.7% of lymphoma and breast cancer patients respectively. The deficiencies and inaccuracies in the OPIS database emphasize the need for caution in basing administrative, policy, or practice decisions on this database.