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Drug rash with eosinophilia and systemic symptoms (DRESS) after an unrelated donor BM transplant

Bone Marrow Transplantation volume 46, pages 1487–1488 (2011)Cite this article

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A 21-year-old Caucasian male diagnosed with AML M7 (FAB) and trilineal dysplasia, refractory to first-line chemotherapy (PETHEMA), underwent an unrelated donor, BM, myeloablative, allogeneic hematopoietic SCT (HSCT) in CR after salvage chemotherapy with three cycles of FLAT (fludarabine, ARA-C and topotecan).

Post-transplant, he developed acute grade III (skin and gut) GVHD, treated with tacrolimus and methylprednisolone, achieving complete resolution on day +28. On day +113, he presented with symptoms suggestive of a late onset digestive aGVHD that was resolved with oral and topical steroids (prednisone and beclomethasone, respectively). At 1-year post transplant, similar symptoms affecting his gut and skin, together with eosinophilia, were interpreted as moderate extensive chronic GVHD. Initially, he was treated with steroids and had a favorable response, but recurrent symptoms after 8 months did not respond either to pravastatin and high-dose steroids or to rapamycin (2-years post transplant) and prednisone (after 1 month). Finally, complete resolution of signs and symptoms of cGVHD affecting his digestive tract and oral mucosae was achieved with four courses of standard dose, single-agent Rituximab. Skin and nail involvement did not improve with the treatment.

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Authors and Affiliations

  1. Servicio de Hematología, Hospital Universitario, Salamanca, Spain

    L López-Anglada, L Vázquez, J A Pérez-Simón, I Dávila, A Santos-Briz, L García & D Caballero

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  1. L López-Anglada
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  2. L Vázquez
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  3. J A Pérez-Simón
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Correspondence to L López-Anglada.

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López-Anglada, L., Vázquez, L., Pérez-Simón, J. et al. Drug rash with eosinophilia and systemic symptoms (DRESS) after an unrelated donor BM transplant. Bone Marrow Transplant 46, 1487–1488 (2011). https://doi.org/10.1038/bmt.2010.324

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