Topical Treatment of Sclerodermoid Chronic Graft vs. Host Disease

Currie, Donald M.; Ludvigsdottir, Gudbjorg Kristin; Díaz, Carlos Alexander Alva; Kamani, Naynesh

doi:10.1097/00002060-200202000-00012

Cited by 10 publications

(20 citation statements)

References 10 publications

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“…Aggressive heat therapy, massage, and passive range-of-motion exercises can help maintain function until the sclerotic process can be controlled. 101 To date, there are no studies specifically evaluating rehabilitative methods in people with chronic GVHD.…”

Section: Minimize Effects On Target Tissuesmentioning

confidence: 99%

New approaches for preventing and treating chronic graft-versus-host disease

Lee

2005

Blood

127

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Despite improvements in the practice of allogeneic hematopoietic stem cell transplantation (HCT) over the last 25 years, chronic graft-versus-host disease (GVHD) remains a substantial problem with little change in the incidence, morbidity, and mortality of this complication. In fact, with increased use of peripheral blood, transplantation of older patients, and less immediate transplantation-related mortality, the prevalence of chronic GVHD may increase. One of the difficulties in combating chronic GVHD is a lack of understanding about the pathophysiology of the syndrome. IntroductionChronic graft-versus-host disease (GVHD) is the most serious and common long-term complication of allogeneic hematopoietic stem cell transplantation (HCT), occurring in 20% to 70% of people surviving more than 100 days. 1,2 Approximately half of affected people have 3 or more involved organs, and treatment typically requires immunosuppressive medications for a median of 1 to 3 years. Because of higher treatment-related (nonrelapse) mortality, chronic GVHD remains the major cause of late death despite its association with a lower relapse rate. 3,4 In addition, secondary malignancies are more common in people with chronic GVHD, particularly of commonly involved tissues such as mouth and skin, suggesting that chronic inflammation, prolonged exposure to immunosuppressive medications, or immune dysregulation facilitates the development of new cancers. 5 Finally, the functional consequences of chronic GVHD organ involvement are major determinants of the health and quality of life of survivors. 6,7 Despite the well-recognized adverse effects of chronic GVHD on the long-term success of allogeneic transplantation, its pathophysiology is poorly understood, and management strategies beyond systemic corticosteroids have not been established.While there are some lessons that can be translated from basic and clinical studies of acute GVHD, several lines of evidence suggest that chronic GVHD is not simply a continuation of acute GVHD, and that separate approaches will be required for its prevention and management. First, except for T-cell depletion and use of umbilical cord blood, the major innovations that have improved acute GVHD rates do not seem to have affected chronic GVHD incidence. Second, while there is significant overlap between the organs involved in acute and chronic GVHD, the distribution of affected organs in chronic GVHD is much broader. Fully evolved chronic GVHD is largely an inflammatory and fibrotic process, while acute GVHD is more likely to reflect apoptosis and necrosis. Although traditionally the boundary between acute and chronic GVHD has been set at 100 days after transplantation, more recent definitions hinge on different clinical manifestations rather than time of onset. Third, while acute GVHD is highly associated with subsequent chronic GVHD, approximately 25% to 35% of chronic GVHD is de novo without any preceding acute manifestations, while 20% to 30% of people who had acute GVHD do not go on to develop chronic GVH...

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Section: Minimize Effects On Target Tissuesmentioning

confidence: 99%

New approaches for preventing and treating chronic graft-versus-host disease

Lee

2005

Blood

127

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“…Although sclerodermoid cGVHD is a disabling disease causing the functional impairment and lowering the performance of activities of daily living (ADL) and quality of life, there is little literature on the rehabilitative treatment in sclerodermoid cGVHD [1]. We report the therapeutic experience on multiple contractures in a sclerodermoid cGVHD patient who complained of difficulty with the performance of ADL.…”

Section: Introductionmentioning

confidence: 99%

“…Graft versus host disease (GVHD) is a major complication of allogenic BMT. GVHD, caused by immunologically competent donor T cells against histoincompatible recipient tissues, is clinically significant in 30-50% of patients receiving BMT [1]. GVHD is a multisystemic disorder and involves skin, gastrointestinal tract, liver, etc.…”

Section: Introductionmentioning

confidence: 99%

“…cGVHD affects 30-50% of allogenic BMT recipients surviving the acute phase of transplantation and involves oral mucosa, submucosal glands, and liver. It occurs by mixture of alloreactive and autoreactive mechanisms [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…Sclerodermoid cGVHD has the manifestations of localized or generalized morphea-like plaques with induration, loss of skin markings and appendages, joint contractures, pain, chronic ulceration, generalized wasting, and pyogenic infection [2]. In sclerodermoid cGVHD, fibrotic changes of skin and subcutaneous tissues cause loss of skin elasticity, which results in reduced range of motion (ROM) and secondary effects such as loss of strength and functional capabilities [1].…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic experience on multiple contractures in sclerodermoid chronic graft versus host disease

Choi

Jang

Han

et al. 2009

Support Care Cancer

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Rehabilitative intervention during and after pediatric hematopoietic stem cell transplantation: An analysis of the existing literature

Rossi

Coppo

Zucchetti

et al. 2016

Pediatric Blood & Cancer

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Hematopoietic stem cell transplantation is a therapeutic strategy for several oncohematological diseases. It increases survival rates but leads to a high incidence of related effects. The objective of this paper was to examine the existing literature on physical exercise interventions among pediatric HSCT recipients to explore the most often utilized rehabilitative assessment and treatment tools. Studies published from 2002 to April 1, 2015 were selected: 10 studies were included. A previous literary review has shown that rehabilitation programs have a positive impact on quality of life. Our analysis identified some significant outcome variables and shared intervention areas.

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Topical Treatment of Sclerodermoid Chronic Graft vs. Host Disease

Cited by 10 publications

References 10 publications

New approaches for preventing and treating chronic graft-versus-host disease

New approaches for preventing and treating chronic graft-versus-host disease

Therapeutic experience on multiple contractures in sclerodermoid chronic graft versus host disease

Rehabilitative intervention during and after pediatric hematopoietic stem cell transplantation: An analysis of the existing literature

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