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Graft-Versus-Host Disease

Skin biopsies for early diagnosis and prognosis of graft-versus-host disease in recipients of allogeneic stem cells from blood or bone marrow

Bone Marrow Transplantation volume 34, pages 345–350 (2004)Cite this article

Abstract

A total of 61 patients with haematological malignancies were randomised either to allogeneic transplantation with blood stem cells (BSC) or bone marrow (BM), of whom 37 patients gave their consent to participate in a skin biopsy trial. Skin biopsies were performed before and after transplantation. The main objective was to assess whether biopsies of normal and affected skin from patients allografted with BSC showed a different histopathological and immunohistochemical pattern as compared to biopsies taken from patients allografted with BM. In addition, we wished to clarify whether sequential skin biopsies could be of prognostic value with regard to graft-versus-host disease (GVHD). Biopsies from normal or affected skin in BSC allografted did not disclose a different pattern as compared to BM transplants. Biopsies taken before the outbreak of acute and chronic GVHD showed no substantial differences between the groups. Irrespective of the type of allograft, the immunohistochemical picture of affected skin consistent with acute GVHD was dominated by a significantly higher number of T-lymphocytes (CD8+). Biopsies from normal skin before the outbreak of GVHD had no predictive value with regard to the development of acute or chronic GVHD. Immunohistochemistry is of supplementary help in distinguishing changes caused by cytotoxic agents from those caused by acute GVHD.

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Acknowledgements

This study was supported by Bergliot and Sigurd Skaugen's ‘Fond til bekjempelse av kreft’. We also thank Hilde Beate Vik, the nurses, the medical staff and the administrative personnel at The Section of Haematology, Medical Department, Rikshospitalet University Hospital, Oslo for their excellent cooperation and patient care, and above all thanks to Marit Hatlestad Nilsen, The Gade Institute, Haukeland University Hospital, Bergen, who deserves our deepest gratitude for her meticulous preparation of the immunohistochemical specimens.

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Authors and Affiliations

  1. Medical Department, The Gade Institute, Haukeland University Hospital, Bergen, Norway

    D Heldal, L Brinch, S A Evensen & G E Tjønnfjord

  2. Section of Biostatistics, The Gade Institute, Haukeland University Hospital, Bergen, Norway

    G Aamodt

  3. Department of Pathology, Rikshospitalet University Hospital, Oslo, Norway

    K Elgjo

  4. Department of Pathology, The Gade Institute, Haukeland University Hospital, Bergen, Norway

    L Sviland

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  1. D Heldal
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  2. L Brinch
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  4. G E Tjønnfjord
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  6. K Elgjo
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Correspondence to D Heldal.

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Heldal, D., Brinch, L., Evensen, S. et al. Skin biopsies for early diagnosis and prognosis of graft-versus-host disease in recipients of allogeneic stem cells from blood or bone marrow. Bone Marrow Transplant 34, 345–350 (2004). https://doi.org/10.1038/sj.bmt.1704568

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