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Skin Graft-versus-host Disease Following Autologous Stem Cell Transplantation for Multiple Myeloma

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Graft-versus-host disease (GVHD) is a common complication of allogeneic stem cell transplantation (allo-SCT). However, a similar syndrome has been reported in autologous stem cell transplantation (ASCT) as well. The target organs of GVHD in ASCT are the skin, liver and gastrointestinal (GI) tract, which are consistent with those in allo-SCT. Histologic findings from the skin and the mucosa of the GI tract also show similar features. Here we describe a case of autologous GVHD involving the skin of a patient who underwent ASCT for multiple myeloma. In this patient, the response to a total prednisone dose of 0.5 mg/kg/day was unsatisfactory, and the patient required more intensive and prolonged immunosuppressive therapy with slow tapering

Abstract

Graft-versus-host disease (GVHD) is a common complication of allogeneic stem cell transplantation (allo-SCT). However, a similar syndrome has been reported in autologous stem cell transplantation (ASCT) as well. The target organs of GVHD in ASCT are the skin, liver and gastrointestinal (GI) tract, which are consistent with those in allo-SCT. Histologic findings from the skin and the mucosa of the GI tract also show similar features. Here we describe a case of autologous GVHD involving the skin of a patient who underwent ASCT for multiple myeloma. In this patient, the response to a total prednisone dose of 0.5 mg/kg/day was unsatisfactory, and the patient required more intensive and prolonged immunosuppressive therapy with slow tapering

참고문헌 (13)

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  2. Fidler, C., "Spontaneous graft versus host disease occurring in a patient with multiple myeloma after autologous stem cell transplant", Am. J. Hematol, 87, pp.219~221 (2012)
  3. Drobyski, W. R., "Severe autologous GVHD after hematopoietic progenitor cell transplantation for multiple myeloma", Bone Marrow Transplant, 43, pp.169~177 (2009)
  4. Goddard, D. S., "A case of severe cutaneous, GI and liver GVHD in a patient with multiple myeloma, status- post-second auto-SCT", Bone Marrow Transplant, 45, pp.409~411 (2010)
  5. Krishna, S. G., "Recurrent spontaneous gastrointestinal graft-versus-host disease in autologous hematopoietic stem cell transplantation", Clin. Lymphoma Myeloma Leuk, 10, pp.E17~E21 (2010)
  6. Baron, F., "Clinical course and predictive factors for cyclosporin-induced autologous graftversus- host disease after autologous haematopoietic stem cell transplantation", Br. J. Haematol, 111, pp.745~753 (2000)
  7. Jones, R. J., "Induction of graft-versus-host disease after autologous bone marrow transplantation", Lancet, 1, pp.754~757 (1989)
  8. Hood, A. F., "Acute graft-vs-host disease. Development following autologous and syngeneic bone marrow transplantation", Arch. Dermatol, 123, pp.745~750 (1987)
  9. Holmberg, L., "Gastrointestinal graft-versus-host disease in recipients of autologous hematopoietic stem cells: incidence, risk factors, and outcome", Biol. Blood Marrow Transplant, 12, pp.226~234 (2006)
  10. Saunders, M. D., "Bile duct apoptosis and cholestasis resembling acute graft-versus- host disease after autologous hematopoietic cell transplantation", Am. J. Surg. Pathol, 24, pp.1004~1008 (2000)
  11. Cogbill, C. H., "Gastrointestinal pathology of autologous graft-versus-host disease following hematopoietic stem cell transplantation: a clinicopathological study of 17 cases", Mod. Pathol, 24, pp.117~125 (2011)
  12. Nellen, R. G., "Eruption of lymphocyte recovery or autologous graft-versus-host disease?", Int. J. Dermatol, 47(Suppl 1), pp.32~34 (2008)
  13. Lazarus, H. M., "Spontaneous autologous graft-versus- host disease in plasma cell myeloma autograft recipients: flow cytometric analysis of hematopoietic progenitor cell grafts", Biol. Blood Marrow Transplant, 17, pp.970~978 (2011)

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