A Clinical Study of Acute Graft-versus-host disease after Allogeneic Bone Marrow Transplantation: Cutaneous Manifestation

Kim, Eui Han; Lee, Dong Won; Lee, Jun Young; Cho, Baik Kee; Lee, Jong Wook; Kim, Chun Choo

Abstract

BACKGROUND: Acute graft-versus-host disease(GVHD) has been a major obstacle of successful allogeneic bone marrow transplantation(BMT). Because the onset of cutaneous graft-versus-host reaction (GVHR) is usually the earliest and certainly the most common form of the disease, cutaneous manifestation of acute GVHD is important to detect as early as possible. Except for a few case reports, there has been no clinical study of acute cutaneous GVHR in Korea so far. OBJECTIVE: We investigated the clinical characteristics of acute cutaneous GVHR in recepients receiving allogeneic BMT from human leukocyte antigen(HLA)-identical sibling donor. METHODS: On the basis of the patients' charts and the records of Catholic BMT center, we investigated the incidence of acute GVHD and the clinical manifestation of acute GVHD occurring in 102 patients of whom 66 patients were confirmed by histopathology. RESULTS: 1. The incidence of acute GVHD was 23.5 %, and the incidence of male and female were 22.4 %, 25.0 % respectively. 2. The cutaneous GVHR usually developed within 10-40 days after BMT and usually the earliest and most common form of the GVHD. 3. The most common cutaneous involvement site were upper extremities and chest and 51.4 % of cutaneous GVHR patients complained pruritus, pain and tenderness. 4. The over all clinical grade was lower than that in western countries. CONCLUSION: We speculate that the lower incidence of acute GVHD and milder clinical characteristics than the reports in the western countries might be related to differences in genetic background.