Abstract Number: 69

Predictive value of skin histology in chronic graft versus host disease

R. Andani , I. Robertson , K. MacDonald , G. Hill , K. Khosrotehrani

Meeting: 2012 Dermcoll

Session Information

Date: -

Session Title: Poster Presentations

Session Time: -

Background: Chronic Graft vs. Host Disease (cGVHD) is a common and often fatal complication following bone marrow transplantation (BMT). Past studies, in animal models, implicate the persistence of host Langerhans cells (LCs) in the development of cGVHD. Our objective was to ask if persistence of host LCs could be predictive of cGVHD in a cohort of sex-mismatched allogenic BMT recipients.
Methods: Skin biopsies of sex-mismatched allogenic BMT recipients were taken 100 days post-transplant. Prospective follow-up information was collected regarding the occur- rence of cGVHD. CD1a staining and X/Y chromosome in-situ hybridization were performed to identify LCs and their origin (host or donor).
Results: From 2005 to 2009, 124 patients received sexmismatched allogenic BMT. We excluded 59 patients who developed acute GVHD and 5 that were lost to follow up before the 100 day biopsy date. We established 23 cases with cutaneous cGVHD to be compared to 37 controls without any cGVHD. Preliminary data on 4 cGVHD cases vs. 4 controls that never developed GVHD were compared.

The mean number of CD1a+ LCs/3 mm biopsy section was 11.2 ± 3 vs. 45.2 ± 9 (p = 0.02, Mann-Whitney U test). FISH was allowed in 68% of LCs to determine their origin. At 100 days, 45% of LCs were host derived. Patients who developed cGVHD had elevated levels of host derived LCs although the difference did not reach signifi cance (p = 0.4).
Conclusion: Skin biopsies at 100 days can indicate the risk of developing cGVHD. However, further studies on our larger patient sample are needed to clarify this risk.