The Skin Biopsy in the Diagnosis of Acute Graft-versus-host Disease in Man

Overview

Journal Am J Pathol

Publisher Elsevier

Specialty Pathology

Date 1977 Dec 1

PMID 23008

Citations 35

Authors

G E Sale

K G Lerner

E A Barker

H M Shulman

E D Thomas

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Aggressive Cutaneous Squamous Cell Carcinomas Following Treatment for Graft-versus-Host Disease: A Case Report and Review of Risk Factors.

Pendlebury G, Bongiorno M, Lackey J Dermatopathology (Basel). 2022; 9(2):122-130.

PMID: 35466244 PMC: 9036292. DOI: 10.3390/dermatopathology9020015.

In Vivo reflectance confocal microscopy of cutaneous acute graft-versus-host disease: concordance with histopathology and interobserver reproducibility of a glossary with representative images.

Saknite I, Gill M, Alessi-Fox C, Zwerner J, Lehman J, Shinohara M J Eur Acad Dermatol Venereol. 2022; 36(7):1034-1044.

PMID: 35175678 PMC: 9232909. DOI: 10.1111/jdv.18004.

Comparative analysis of intrinsic skin aging between Caucasian and Asian subjects by slide-free in vivo harmonic generation microscopy.

Lin K, Liao Y, Wei M, Sun C J Biophotonics. 2019; 13(4):e201960063.

PMID: 31747129 PMC: 7894538. DOI: 10.1002/jbio.201960063.

Autologous GVHD?.

Otegbeye F, Gale R, Lazarus H Bone Marrow Transplant. 2014; 49(11):1349-51.

PMID: 25089596 DOI: 10.1038/bmt.2014.169.

Cardiac effects of chronic graft-versus-host disease after stem cell transplantation.

Dogan A, Dogdu O, Ozdogru I, Yarlioglues M, Kalay N, Inanc M Tex Heart Inst J. 2013; 40(4):428-34.

PMID: 24082373 PMC: 3783135.

References

Kennedy B, Smith L, GOLTZ R . Skin changes secondary to hydroxyurea therapy. Arch Dermatol. 1975; 111(2):183-7. View

Spielvogel R, Ullman S, GOLTZ R . Skin changes in graft-vs-host disease. South Med J. 1976; 69(10):1277-81. DOI: 10.1097/00007611-197610000-00009. View

de Vries M, CROUCH B, van PUTTEN L, van BEKKUM D . Pathologic changes in irradiated monkeys treated with bone marrow. J Natl Cancer Inst. 1961; 27:67-97. View

DAngio G, Farber S, Maddock C . Potentiation of x-ray effects by actinomycin D. Radiology. 1959; 73:175-7. DOI: 10.1148/73.2.175. View

Thomas E, Buckner C, Banaji M, Clift R, Fefer A, Flournoy N . One hundred patients with acute leukemia treated by chemotherapy, total body irradiation, and allogeneic marrow transplantation. Blood. 1977; 49(4):511-33. View

Greco F, Brereton H, KENT H, Zimbler H, Merrill J, Johnson R . Adriamycin and enhanced radiation reaction in normal esophagus and skin. Ann Intern Med. 1976; 85(3):294-8. DOI: 10.7326/0003-4819-85-3-294. View

Krueger G, Graw Jr R, Rogentine G, Darrow 2nd C, NEEFE J, Luetzeler J . Pathology of modified graft-versus-host disease in bone marrow allografted monkeys treated with antilymphocyte serum. Blut. 1975; 30(1):19-30. DOI: 10.1007/BF01633783. View

Thomas E, Storb R, Clift R, Fefer A, Johnson F, Neiman P . Bone-marrow transplantation (first of two parts). N Engl J Med. 1975; 292(16):832-43. DOI: 10.1056/NEJM197504172921605. View

Thomas E, Storb R, Clift R, Fefer A, Johnson L, Neiman P . Bone-marrow transplantation (second of two parts). N Engl J Med. 1975; 292(17):895-902. DOI: 10.1056/NEJM197504242921706. View

10.

Cohen I, Mosher M, Okeefe E, Klaus S, De Conti R . Cutaneous toxicity of bleomycin therapy. Arch Dermatol. 1973; 107(4):553-5. View

11.

Blum R, Carter S, Agre K . A clinical review of bleomycin--a new antineoplastic agent. Cancer. 1973; 31(4):903-14. DOI: 10.1002/1097-0142(197304)31:4<903::aid-cncr2820310422>3.0.co;2-n. View

12.

Baker J, FLEISCHMAN R, Thompson G, SCHAEPPI U, Ilievski V, Cooney D . Pathological effects of bleomycin on the skin of dogs and monkeys. Toxicol Appl Pharmacol. 1973; 25(2):190-200. DOI: 10.1016/s0041-008x(73)80005-5. View

13.

Glucksberg H, Storb R, Fefer A, Buckner C, Neiman P, Clift R . Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors. Transplantation. 1974; 18(4):295-304. DOI: 10.1097/00007890-197410000-00001. View

14.

Lerner K, Kao G, Storb R, Buckner C, Clift R, Thomas E . Histopathology of graft-vs.-host reaction (GvHR) in human recipients of marrow from HL-A-matched sibling donors. Transplant Proc. 1974; 6(4):367-71. View

15.

Slavin R, SANTOS G . The graft versus host reaction in man after bone marrow transplantation: pathology, pathogenesis, clinical features, and implication. Clin Immunol Immunopathol. 1973; 1(4):472-98. DOI: 10.1016/0090-1229(73)90005-6. View

16.

Koss L . A light and electron microscopic study of the effects of a single dose of cyclophosphamide on various organs in the rat. I. The urinary bladder. Lab Invest. 1967; 16(1):44-65. View

17.

Kruger G, BERARD C, DeLellis R, Graw Jr R, Yankee R, Leventhal B . Graft-versus-host disease. Morphologic variation and differential diagnosis in 8 cases of HL-A matched bone marrow transplantation. Am J Pathol. 1971; 63(2):179-202. PMC: 2047494. View

18.

Smith C, GELFANT S . Effects of methotrexate and hydroxyurea on psoriatic epidermis. Preferential cytotoxic effects on psoriatic epidermis. Arch Dermatol. 1974; 110(1):70-2. View

19.

Woodruff J, Butcher W, Hellerstein L . Early secondary disease in the rhesus monkey. II. Electron microscopy of changes in mucous membranes and external epithelia as demonstrated in the tongue and lip. Lab Invest. 1972; 27(1):85-98. View

20.

Woodruff J, Eltringham J, CASEY H . Early secondary disease in the Rhesus monkey. I. A comparative histopathologic study. Lab Invest. 1969; 20(6):499-511. View