Immunohistological Skin Alterations in Allogeneic Bone Marrow Transplantation

Overview

Journal Klin Wochenschr

Specialty General Medicine

Date 1984 Jul 16

PMID 6381872

Citations 5

Authors

C Muller

P Ostendorf

P Wernet

K Schuch

H Wahl

H D Waller

Affiliations

Soon will be listed here.

Abstract

Skin biopsies of 26 patients with leukemia and seven patients with aplastic anemia were investigated before and at different stages after allogeneic bone marrow transplantation (BMT) to establish the immunological criteria which distinguish skin alterations during normal reconstitution from dermal lesions mediated by graft-versus-host disease (GvHD). Of the 33 patients studied 27 presented with clinically diagnosed acute and/or chronic GvHD, one patient died of bone marrow rejection. Immunohistological analysis of the respective skin biopsies with selected monoclonal antibodies against human leukocyte antigens (HLA) and differentiation antigens of the lympho-hematopoietic cells revealed low dermal mononuclear cell counts with phenotypically normal constituents in five cases with uncomplicated reconstitution post-grafting. In contrast, increased dermal cellular infiltrates predominantly consisting of Lyt 3+, OKT 8+ T-lymphocytes, as well as of a large number of Ia-like (immune response associated = HLA-D) determinant + monocytes/macrophages were observed in all patients with active acute/chronic GvH reactivity. As sign of activation simultaneous expression of HLA-D region products was also found on a subset of the invading OKT8+ T-lymphocytes. Progression of GvHD was associated with additional surface staining of keratinocytes for Ia-like determinants. Loss of Ia-like determinant+, OKT6+ dentritic epithelial cells in all leukemic patients, as well as in patients with aplastic anemia with or without GvHD suggested damage of Langerhans cells due to the previous radiotherapy and/or specific immunological destruction. In patients with fatal outcome of GvHD prolonged reduction of these dentritic epithelial cells seemed to be indicative of impaired immune reconstitution or bone marrow dysfunction. Thus immunopathological features of skin GvHR may enable early recognition and prognostic evaluation of this disease possibly allowing more effective therapy.

Citing Articles

Correlation of interstitial pneumonia with human cytomegalovirus-induced lung infection and graft-versus-host disease after bone marrow transplantation.

Muller C, Hebart H, Roos A, Roos H, Steidle M, Einsele H Med Microbiol Immunol. 1995; 184(3):115-21.

PMID: 8577311 DOI: 10.1007/BF00224347.

[Bone marrow transplantation in acute leukemia, chronic myeloid leukemia, severe aplastic anemia and stage IV neuroblastoma. Effect of antiviral prevention with anti-CMV-hyperimmunoglobulin and acyclovir].

Ostendorf P, Ehninger G, Dopfer R, Schmidt H, Haen M, Link H Klin Wochenschr. 1986; 64(10):453-66.

PMID: 3014203 PMC: 7095994. DOI: 10.1007/BF01713171.

Drug-induced skin reactions and acute cutaneous graft-versus-host reaction: a comparative immunohistochemical study.

Drijkoningen M, De Wolf-Peeters C, Tricot G, Degreef H, Desmet V Blut. 1988; 56(2):69-73.

PMID: 2963669 DOI: 10.1007/BF00633465.

T lymphocytes expressing HECA-452 epitope are present in cutaneous acute graft-versus-host disease and erythema multiforme, but not in acute graft-versus-host disease in gut organs.

Davis R, Smoller B Am J Pathol. 1992; 141(3):691-8.

PMID: 1381561 PMC: 1886711.

Influence of human cytomegalovirus on immune reconstitution after bone marrow transplantation.

Muller C, Einsele H Ann Hematol. 1992; 64 Suppl:A140-2.

PMID: 1322185 DOI: 10.1007/BF01715368.

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