GVHD dry eyes treated with autologous serum tears

Rocha, Eduardo Melani; Pelegrino, Flavia S. A.; Paiva, Cintia S. de; Vigorito, Afonso Celso; Souza, Cármino Antônio de

doi:10.1038/sj.bmt.1702334

Cited by 122 publications

(82 citation statements)

References 6 publications

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“…For more symptomatic patients, cyclosporine and/or steroid eye drop may be used, but cyclosporine eye drop may irritate the eyes. Eye drops made of autologous serum has been tried and very effective in some cases [159]. Scleral contact lenses, a large size contact lens which rests on sclera and creates a tear-filled vault over the cornea, may help in refractory cases.…”

Section: Eye Gvhdmentioning

confidence: 99%

State-of-the-art acute and chronic GVHD treatment

Jamil

Mineishi

2015

Int J Hematol

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owing to the advancement in reduced intensity conditioning (RIC) and in patients without HLA-matched donors due to the use of cord blood and haploidentical HSCT [4][5][6]. Although marked improvement has been made in supportive care, immunosuppressive therapy and DNA-based Human Leukocyte Antigen (HLA) typing, graft vs host disease (GVHD) remains a major cause of morbidity and non-relapse mortality among allogeneic HSCT recipients. It was first described by Billingham in 1966 as a syndrome where immunocompetent T cells from the donor recognize and damage the host tissue in an immunocompromised recipient. It presents with heterogeneous symptoms involving multiple organ systems including gastrointestinal tract, skin, mucosa, liver and lungs [7]. In the past clinical features occurring within 100 days after HSCT was called acute GVHD (aGVHD) and those happening after 100 days were labeled chronic GVHD (cGVHD) [8,9]. This definition was rather unsatisfactory thus National Institute of Health (NIH) consensus criteria were developed and have been revised. The criteria have added new categories such as late-onset aGVHD (acute GVHD occurring after 100 days) and overlap syndrome which includes features of both acute and chronic GVHD to the classification, and also have introduced new definitions for organ system involvement [10][11][12]. The categorization of acute vs chronic GVHD is based on the combination of clinical symptoms rather than the time of onset. Depending upon a number of variables associated with patients, donors, and types of transplant, the incidence of aGVHD varies with incidence of grade II-IV GVHD at 40 % in matched related donor (MRD) transplant to 50 % in MUD transplant. The main risk factors for aGVHD include degree of HLA mismatch, age of the patient, previous all immunization of the donor and the kind of GVHD prophylaxis used. About 30-70 % of allogeneic HSCT recipients alive after 100 days will Abstract Graft-versus-host disease (GVHD) remains as the major obstacle for successful hematopoietic stem cell transplant (HSCT). Roughly half of the patients undergoing HSCT develop GVHD which requires treatment, and above 10 % of the patient may die because of it. However, GVHD presents with anti-tumor activity, called graft-versus-tumor (GVT) effect, and it carries significant anti-tumor activity, thus suppressing GVHD completely may increase the relapse of original disease. Thus, it is important to control GVHD to the appropriate level.

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Section: Eye Gvhdmentioning

confidence: 99%

State-of-the-art acute and chronic GVHD treatment

Jamil

Mineishi

2015

Int J Hematol

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“…Dry eye is one of the major symptoms of cGVHD. 1,2 Although several therapies have been used to minimize the symptoms of dry eyes associated with cGVHD, [3][4][5] an effective treatment has not been established.…”

mentioning

confidence: 99%

Autologous serum eye drops for the treatment of severe dry eye in patients with chronic graft-versus-host disease

Ogawa

Okamoto

Mori

et al. 2003

Bone Marrow Transplant

237

142

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“…10 Patients have reported that the duration of symptomatic relief from serum tears is longer than artificial tears. 11 The rationale for treatment is based on the fact that vitamins and growth factors found in tears are also found in serum.…”

Section: Commentmentioning

confidence: 99%

“…Autologous serum tears have been successfully used in the treatment of dry eye secondary to Sjogren's syndrome, cicatricial pemphigoid, Stevens-Johnson syndrome, and superior limbic keratitis. 12 Local variations in strength (20-100%) 10,12 and preparation of autologous serum tears exist. In our patient, a strength of 100% was used, made from 60 ml clotted blood centrifuged at 2000 revs/min for 5-10 min.…”

Section: Commentmentioning

confidence: 99%