Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation

KOÇYİĞİT, Pelin; ilhan, osman; Soydan, Ender; AKAY, Bengü Nisa; Arat, Mutlu; Sanli, Hatice

Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation

Hatice ŞANLI, (Ankara Üniversitesi, Tıp Fakültesi, Dermatoloji Anabilim Dalı, Ankara, Türkiye)

Bengü Nisa AKAY, (Ankara Üniversitesi, Tıp Fakültesi, Dermatoloji Anabilim Dalı, Ankara, Türkiye)

Ender SOYDAN, (Ankara Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Pelin KOÇYİĞİT, (Ankara Üniversitesi, Tıp Fakültesi, Dermatoloji Anabilim Dalı, Ankara, Türkiye)

Mutlu ARAT, (Ankara Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Osman İLHAN (Ankara Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Turkish Journal of Hematology

3 0

Yıl: 2010 Cilt: 27 Sayı: 2 Sayfa Aralığı: 91 - 98 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation

Öz:

Amaç: Allogeneik hematopoietik kök hücre nakli (Allo-HKHN) sonrası gelişen sklerodermatoz graft-versus-host hastalığının(GVHH) klinik özelliklerinin değerlendirilmesi amaçlanmıştır.Yöntem ve Gereçler: Allo-HKHN yapılan 423 hasta retrospektif olarak analiz edilmiştir. Olguların yaş, cinsiyet, transplantasyon öncesi tanıları, hazırlık rejimleri, GVHH proflaksileri, akut GVHH ve/veya kronik likenoid ve kronik sistemik GVHHmevcudiyeti ve gelişen sklerodermatoz GVHH’nın klinik özellikleri değerlendirilmiştir.Bulgular: Sklerotik lezyonlar 22 hastada ortalama 752±647 gün (ortanca 480) sonra gelişmiştir. Akut GVHH 17 hastadagelişirken, bunların 2’sinde karaciğer, 2’sinde gastrointestinal sistem ve 14’ünde deri tutulumu gözlenmiştir. Yaygın kronikGVHH (karaciğer, akciğer, deri ve oral mukoza) 12 hastada gelişmiştir. Skleroz 19 hastada (%86.4) jeneralize, 3 hastada(%13.6) lokalizeydi. Jeneralize sklerodermatoz değişiklikler izlenen 19 hastanın 8’inde (%36.4) leopar derisi görünümü mevcuttu. Olguların çoğunda sklerotik lezyonlar gövdede yerleşirken, ekstremitelerin distali etkilenmemiştir. Olguların 8’ilikenoid GVHH’dan sklerodermatoz GVHH’ye dönüşürken, 2’sinde her iki faz bir arada ve 12’sinde sklerodermatoz GVHHdenovo olarak gelişmiştir. Beş olgu transplantasyonla ilişkili geç komplikasyonlar nedeniyle vefat etmiştir Sonuç: Sklerodermatoz GVHH geç başlangıçlı ve hastalar için oldukça sıkıntı oluşturabilen bir tablodur. Sklerodermanınaksine akral tutulum nadiren görülür. Lezyonlar hastalık seyri boyunca kaybolmamakla birlikte pek çok olguda prognoz iyidir.

Anahtar Kelime:

Konular: Hematoloji

Allogeneik hematopoietik hücre nakli sonrası sklerodermatoz tip graft-versus- host hastalığının klinik yönleri

Öz:

Objective: We aimed to evaluate the clinical features of sclerodermatous chronic graft-versus-host disease (GVHD) afterallogeneic hematopoietic stem cell transplantation (AHSCT). Materials and Methods: We retrospectively analyzed 423 patients who underwent AHSCT. We assessed age, sex, pretransplant diagnosis, conditioning regimen, GVHD prophylaxis, and occurrence of acute GVHD (aGVHD), chronic lichenoidand chronic systemic GVHD, and clinical properties of sclerodermatous GVHD.Results: Sclerotic skin lesions developed in 22 patients after a mean of 752±647 days (median 480). aGVHD appearedin 17 patients, with hepatic involvement in 2, gastrointestinal tract involvement in 2 and skin involvement in 13 of thesepatients. Extensive chronic GVHD (liver, pulmonary, skin and oral mucosa) developed in 12 patients. Sclerosis was generalized in 19 patients (86.4%) and localized in 3 patients (13.6%). Leopard skin eruption appeared in 8 (36.4%) of the 19patients with generalized sclerodermatous changes. In most cases, sclerotic lesions appeared on the trunk, and distalparts of the extremities were spared. Eight patients (36.4%) progressed from lichenoid to sclerodermatous lesions, 2(9.1%) with lichenoid and sclerodermatous phases together and 12 (55.5%) with de novo sclerodermatous lesions. Fivepatients died because of late transplant-related complications.Conclusion: Sclerodermatous GVHD has a late onset and may be quite disabling. Unlike scleroderma, acral involvementis seen rarely. Although most lesions do not disappear in the course of the disease, most patients have a good prognosis.

Anahtar Kelime:

Konular: Hematoloji

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Sanli H, AKAY B, Soydan E, KOÇYİĞİT P, Arat M, ilhan o (2010). Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation. , 91 - 98.
Chicago	Sanli Hatice,AKAY Bengü Nisa,Soydan Ender,KOÇYİĞİT Pelin,Arat Mutlu,ilhan osman Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation. (2010): 91 - 98.
MLA	Sanli Hatice,AKAY Bengü Nisa,Soydan Ender,KOÇYİĞİT Pelin,Arat Mutlu,ilhan osman Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation. , 2010, ss.91 - 98.
AMA	Sanli H,AKAY B,Soydan E,KOÇYİĞİT P,Arat M,ilhan o Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation. . 2010; 91 - 98.
Vancouver	Sanli H,AKAY B,Soydan E,KOÇYİĞİT P,Arat M,ilhan o Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation. . 2010; 91 - 98.
IEEE	Sanli H,AKAY B,Soydan E,KOÇYİĞİT P,Arat M,ilhan o "Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation." , ss.91 - 98, 2010.
ISNAD	Sanli, Hatice vd. "Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation". (2010), 91-98.

APA	Sanli H, AKAY B, Soydan E, KOÇYİĞİT P, Arat M, ilhan o (2010). Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation. Turkish Journal of Hematology, 27(2), 91 - 98.
Chicago	Sanli Hatice,AKAY Bengü Nisa,Soydan Ender,KOÇYİĞİT Pelin,Arat Mutlu,ilhan osman Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation. Turkish Journal of Hematology 27, no.2 (2010): 91 - 98.
MLA	Sanli Hatice,AKAY Bengü Nisa,Soydan Ender,KOÇYİĞİT Pelin,Arat Mutlu,ilhan osman Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation. Turkish Journal of Hematology, vol.27, no.2, 2010, ss.91 - 98.
AMA	Sanli H,AKAY B,Soydan E,KOÇYİĞİT P,Arat M,ilhan o Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation. Turkish Journal of Hematology. 2010; 27(2): 91 - 98.
Vancouver	Sanli H,AKAY B,Soydan E,KOÇYİĞİT P,Arat M,ilhan o Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation. Turkish Journal of Hematology. 2010; 27(2): 91 - 98.
IEEE	Sanli H,AKAY B,Soydan E,KOÇYİĞİT P,Arat M,ilhan o "Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation." Turkish Journal of Hematology, 27, ss.91 - 98, 2010.
ISNAD	Sanli, Hatice vd. "Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation". Turkish Journal of Hematology 27/2 (2010), 91-98.