Differential diagnosis of skin lesions after allogeneic haematopoietic stem cell transplantation

Dijk, Marijke R. Canninga‐van; Sanders, C. J. G.; Verdonck, Leo F.; Fijnheer, Rob; Tweel, Jan G. van den

doi:10.1046/j.1365-2559.2003.01591.x

Cited by 34 publications

(17 citation statements)

References 150 publications

(212 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As reported, 23 only minimal immune cell infiltrates could be observed in patients with chronic GVHD: total numbers of T cells were within the range of T-cell infiltrates usually observed in healthy individuals (data not shown). However, the percentage of skin-infiltrating CD8 + T cells was significantly higher when compared to healthy controls (P<0.05; Figure 1C).…”

supporting

confidence: 71%

The immunological phenotype of rituximab-sensitive chronic graft-versus-host disease: a phase II study

Dorp¹,

Resemann²,

Boome³

et al. 2011

Haematologica

View full text Add to dashboard Cite

1380haematologica | 2011; 96(9) IntroductionGraft-versus-host-disease (GVHD) is the most common and life-threatening complication after allogeneic stem cell transplantation (allo-SCT).1,2 B-cell depletion with rituximab (RTX) has been successful in steroid-refractory chronic GVHD, showing response rates of 43-80%. [3][4][5][6][7][8] However, the nature of B-cell contribution, as well as to what extent B-cell depletion can restore physiological conditions, has so far not been clarified. Hypotheses obtained from mouse models of chronic GVHD and retrospective analysis of patient materials have been conflicting. For example, a correlation was found between high levels of B-cell activating factor (BAFF) in a retrospective analysis of 45 patients with active chronic GVHD.9 However, no significant correlation could be found between the levels of BAFF and RTX-responsiveness in the most recently published prospective phase II study of 37 patients. 10 In active chronic GVHD prior to response to immunosuppressants, expansion of activated CD27 + B cells has been observed. 9 Another retrospective study of 35 patients suffering from active chronic GVHD, in which treatment included prednisone and calcineurin inhibitors, showed significantly lower numbers of memory B cells (CD27 + ). 11 To our knowledge, no prospective comparisons have been made between immune subsets before and after B-cell depletion therapy of steroid-refractory chronic GVHD, so details on reestablishment of normal B-cell pools after RTX treatment, as well as changes in immune-pathology of the skin, still have to be clarified. Consequently, the aim of this study was to demonstrate effectiveness of B-cell depletion therapy in steroid-refractory chronic GVHD and to identify potentially involved cell subsets by a comprehensive immunological analysis in a prospective clinical trial. Design and Methods Patients and patient materialIn the course of a prospective study (Eudra-CT 2008-004125-42), a cohort of 20 chronic GVHD patients who received allo-SCT due to various hematologic malignancies was treated with 4 weekly doses of 375 mg/m 2 RTX (F. Hoffmann-La Roche Ltd., Basel, Switzerland). All patients had chronic GVHD with at least skin symptoms. Inclusion criteria were age over 18 years, life-expectancy of more than six months, and a World Health Organization (WHO)The immunological phenotype of rituximab-sensitive chronic graft-versus-host disease: a phase II study Chronic graft-versus-host disease is the major long-term complication after allogeneic stem cell transplantation with a suboptimal response rate to current treatments. Therefore, clinical efficacy and changes in lymphocyte subsets before and after rituximab treatment were evaluated in a prospective phase II study in patients with steroid-refractory chronic graft-versushost disease. Overall response rate was 61%. Only responding patients were found to have increased B-cell numbers prior to treatment. B cells had a naïve-antigen-presenting phenotype and were mainly CD5 negative or had a low CD5 expression...

show abstract

supporting

confidence: 71%

The immunological phenotype of rituximab-sensitive chronic graft-versus-host disease: a phase II study

Dorp¹,

Resemann²,

Boome³

et al. 2011

Haematologica

View full text Add to dashboard Cite

show abstract

“…Chronic graft-versus-host disease (cGVHD) is the most important determinant of long-term morbidity [1][2][3][4][5] in patients undergoing allogeneic stem cell transplantation (SCT). Several investigational treatments have been performed in immunosuppressive therapyrefractory cGVHD, [6][7][8] but only few patients have responded to such treatments.…”

Section: Introductionmentioning

confidence: 99%

Anti-CD20 monoclonal antibody treatment in 6 patients with therapy-refractory chronic graft-versus-host disease

Dijk

Straaten

Fijnheer

et al. 2004

Blood

125

View full text Add to dashboard Cite

Chronicgraft-versus-host disease (cGVHD) is an important determinant of long-term morbidity and mortality in allogeneic stem cell transplantation patients. Because cGVHD has clinical, histologic, and laboratory findings of autoimmune diseases and anti-B-cell therapy has shown efficacy in autoimmune diseases, we hypothesized that monoclonal anti-CD20 antibody therapy might improve patients with cGVHD. We treated 5 men and 1 woman with therapy-refractory extensive cGVHD with anti-CD20 monoclonal antibody. Intravenous infusion was given at a weekly dose of 375 mg/m 2 for 4 weeks. In case of incomplete clinical response, additional courses of 4 weeks were given. Five patients responded to treatment with marked clinical, biochemical, and histologic improvement. One patient failed to respond. Anti-CD20 monoclonal antibody seems to be effective in cGVHD. A controlled trial is mandatory to confirm these results. The outcome of this study suggests a participating role of B cells in the pathogenesis of cGVHD.

show abstract

“…18 Furthermore, cutaneous GVHD is composed of polyclonal T lymphocytes. 19 In the present study, acute cutaneous GVHD occurred after transplantation; T-cell PTLD was diagnosed at just over 6.5 years after the allo-HSCT with the primary site being the distal femur, but it was not associated with EBV infection.…”

Section: Discussionmentioning

confidence: 49%

Primary distal femur T-cell lymphoma after allogeneic haematopoietic stem cell transplantation for chronic myeloid leukaemia: A rare case report and literature review

Han

Sun

et al. 2014

J Int Med Res

View full text Add to dashboard Cite

Post-transplant lymphoproliferative disorders originating from T lymphocytes are a rare complication of allogeneic haematopoietic stem cell transplantation (allo-HSCT) that are not usually associated with Epstein-Barr virus infection. A male patient diagnosed at the age of 15 years with chronic myeloid leukaemia (in the chronic phase) was initially treated with oral hydroxyurea. The disease entered an accelerated phase when the patient was 22 years old. Complete remission was achieved after one course of homoharringtonine and cytarabine. The patient then underwent human leucocyte antigen-matched sibling donor allo-HSCT. Just over 6.5 years after the allo-HSCT, a second primary tumour was located in the distal femur and diagnosed as T-cell non-Hodgkin's lymphoma (stage IV, group B). This was treated with various chemotherapy and radiotherapy regimens, but the outcomes were poor and the disease progressed. The T-cell lymphoma invaded many sites, including the skeleton, spleen and skin, and the patient died within 8 months of the diagnosis. This current case report highlights the need for the early detection and prevention of subsequent primary malignancies after allo-HSCT.

show abstract

Differential diagnosis of skin lesions after allogeneic haematopoietic stem cell transplantation

Cited by 34 publications

References 150 publications

The immunological phenotype of rituximab-sensitive chronic graft-versus-host disease: a phase II study

The immunological phenotype of rituximab-sensitive chronic graft-versus-host disease: a phase II study

Anti-CD20 monoclonal antibody treatment in 6 patients with therapy-refractory chronic graft-versus-host disease

Primary distal femur T-cell lymphoma after allogeneic haematopoietic stem cell transplantation for chronic myeloid leukaemia: A rare case report and literature review

Contact Info

Product

Resources

About