Sale G E, Lerner K G, Barker E A, Shulman H M, Thomas E D
Am J Pathol. 1977 Dec;89(3):621-36.
Criteria for diagnosis of acute graft-versus-host disease (GVHD) using skin biopsies were derived from a) general experience with more than 300 human marrow grafts and b) the results of "blind" studies of skin biopsy specimens of patients grafted with either allogeneic or syngeneic marrow. Large doses of cytotoxic drugs and irradiation given before grafting can produce transient skin changes interfering significantly with the diagnosis of GVHD. Artifacts can also cause difficulty. Epidermal cytologic atypia, dyskeratosis, and satellitosis were present both in allografted patients with acute clinical GVHD of multiple systems and in patients given autologous or syngeneic marrow. Due to the marked overlap in histopathologic findings between these two types of skin injury, frequent serial skin biopsies must be combined with all other available clinical and biopsy data to provide reliable diagnosis of acute GVHD in man.
利用皮肤活检诊断急性移植物抗宿主病（GVHD）的标准源自：a）300多例人类骨髓移植的一般经验；b）对接受同种异体或同基因骨髓移植患者的皮肤活检标本进行“盲法”研究的结果。移植前给予大剂量细胞毒性药物和放疗可产生短暂的皮肤变化，严重干扰GVHD的诊断。人为因素也会造成困难。在多系统急性临床GVHD的同种异体移植患者以及接受自体或同基因骨髓移植的患者中，均存在表皮细胞异型性、角化不良和卫星现象。由于这两种皮肤损伤在组织病理学表现上有明显重叠，必须将频繁的系列皮肤活检与所有其他可用的临床和活检数据相结合，才能对人类急性GVHD作出可靠诊断。
