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异基因造血细胞移植后皮肤移植物抗宿主病的临床表现:土耳其单中心长期随访结果

Clinical manifestations of cutaneous graft-versus-host disease after allogeneic haematopoietic cell transplantation: long-term follow-up results in a single Turkish centre.

作者信息

Sanli Hatice, Ekmekçi Pelin, Arat Mutlu, Gürman Günhan

机构信息

Department of Dermatology, Stem Cell Transplantation Unit, School of Medicine, Ankara University, Ankara, Turkey.

出版信息

Acta Derm Venereol. 2004;84(4):296-301. doi: 10.1080/00015550410025840.

Abstract

The aim of this study was to evaluate the clinical manifestations of cutaneous graft-versus-host disease (GVHD) developed after allogeneic haematopoietic cell transplantation. In all, 67 patients were evaluated: 49 patients developed acute GVHD, 17 patients developed de novo chronic GVHD and 29 developed secondary chronic (15 limited, 14 progressive) GVHD following acute cutaneous GVHD. Of the 46 patients with chronic GVHD, lichenoid lesions were observed in 32 and sclerodermoid lesions were observed in 12. In four patients with sclerodermoid cutaneous GVHD, these lesions occurred after a lichenoid phase. Oral lesions were present in 61% of the patients and six of them had only oral mucosal involvement without any skin lesions. Nail lesions were observed in 31% of the patients. During the follow-up period 15 patients with GVHD died and in 7 of them the cause of death was related to chronic GVHD. In conclusion, GVHD has a wide spectrum of cutaneous manifestations, which can be used as an important tool for the early diagnosis of the disease.

摘要

本研究的目的是评估异基因造血细胞移植后发生的皮肤移植物抗宿主病(GVHD)的临床表现。总共评估了67例患者:49例发生急性GVHD,17例发生新发慢性GVHD,29例在急性皮肤GVHD后发生继发性慢性(15例局限性,14例进行性)GVHD。在46例慢性GVHD患者中,32例观察到苔藓样病变,12例观察到硬皮病样病变。在4例硬皮病样皮肤GVHD患者中,这些病变发生在苔藓样期之后。61%的患者存在口腔病变,其中6例仅有口腔黏膜受累,无任何皮肤病变。31%的患者观察到指甲病变。在随访期间,15例GVHD患者死亡,其中7例的死亡原因与慢性GVHD有关。总之,GVHD有广泛的皮肤表现,可作为该病早期诊断的重要工具。

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