Cutaneous Chronic Graft Versus Host Disease Following Allogeneic Haematopoietic Stem Cell Transplantation in Children: A Retrospective Study

Shreberk‐Hassidim, Rony; Neumark, Michal; Greenberger, Shoshana; Gal, Gilad; Hassidim, Ayal; Dukler, Yuval; Maly, Alexander; Stepensky, Polina; Molho‐Pessach, Vered

doi:10.2340/00015555-2824

Cited by 4 publications

(8 citation statements)

References 17 publications

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“…In addition to these findings, age at time of transplantation was a significant risk factor for the occurrence of chronic GVHD (P = 0.003). This is in line with the reported observation that older patient age is associated with an increased development of chronic GVHD (Bernaudin et al 2020;Shreberk-Hassidim et al 2018).…”

Section: Multivariate Analysissupporting

confidence: 91%

Association of recipient and donor interleukin 6 polymorphisms 174 and 597 with outcome after allogeneic hematopoietic stem cell transplantation in children

Wetzel

Wittig

Gruhn

2021

J Cancer Res Clin Oncol

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Purpose The success of allogeneic hematopoietic stem cell transplantation (HSCT) is compromised by complications such as infection, relapse, and graft-versus-host disease (GVHD). The investigation of non-HLA immunogenetics, particularly of cytokines, could identify predictors of an unfavorable outcome after allogeneic HSCT. In this study, we examined the impact of single nucleotide polymorphisms (SNPs) within the promoter region of interleukin 6 (IL6) on the development of GVHD after pediatric allogeneic HSCT. Methods In this retrospective analysis, we included 320 pediatric patients with a median age of 10 years who underwent an allogeneic HSCT and their respective donors. We used TaqMan real-time polymerase chain reaction to analyze the SNPs IL6-174 (G/C) and IL6-597 (G/A). The IL6-174 polymorphism was examined in 300 recipients and 295 donors. The IL6-597 polymorphism was analyzed in 299 recipients and 296 donors. We investigated the influence of the IL6-174 and IL6-597 polymorphisms on overall survival, event-free survival, relapse incidence, transplant-related mortality, and the occurrence of GVHD. Results G polymorphism at position 174 of the recipient IL6 gene was associated with a higher incidence of acute GVHD (GG vs. GC/CC; P = 0.024). Patients with IL6-597 GG genotype developed acute GVHD more frequently than individuals with an A allele (GG vs. GA vs. AA; P = 0.013). IL6-174 GG homozygous recipients had a more frequent occurrence of chronic GVHD (GG vs. GC/CC; P = 0.049). We observed a significant increased risk of chronic GVHD in recipients with IL6-597 GG genotype (GG vs. GA vs. AA; P = 0.043). Polymorphisms of donors did not affect the incidence of acute GVHD and chronic GVHD. In multivariate analysis, the IL6-174 and IL6-597 SNPs were independent significant risk factors for acute GVHD (P = 0.030; P = 0.007, respectively) as well as for chronic GVHD (P = 0.045; P = 0.015, respectively). In addition, older age at time of transplantation turned out to be a significant risk factor for chronic GVHD (P = 0.003). Conclusion Our study identified the IL6-174 and IL6-597 GG genotypes of pediatric allogeneic HSCT recipients as genetic risk factors for the development of acute GVHD and chronic GVHD. After evaluations in further studies, these findings could implicate the adjustment of prophylactic measures to reduce the occurrence of acute GVHD and chronic GVHD.

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Section: Multivariate Analysissupporting

confidence: 91%

Association of recipient and donor interleukin 6 polymorphisms 174 and 597 with outcome after allogeneic hematopoietic stem cell transplantation in children

Wetzel

Wittig

Gruhn

2021

J Cancer Res Clin Oncol

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“…The effects of corticosteroid creams, solutions or ointments on c-GvHD were studied in a few of the papers included in this review, [45][46][47] generally in association with systemic therapies and/ or other immunomodulating treatments (e.g. extracorporeal photopheresis, PUVA).…”

Section: Discussionmentioning

confidence: 99%

“…extracorporeal photopheresis, PUVA). Topical steroids were used as first‐line treatment in association with emollients and topical CNIs in patients affected by localized mild‐to‐moderate skin c‐GvHD 47 and in association with emollients and antihistamines in those with diffuse eczematoid c‐GvHD 45 . Associating topical CNIs with steroid appeared to be effective, while steroids without other immunosuppressants seemed not to be.…”

Section: Discussionmentioning

confidence: 99%

“…Four papers 41,45,46,47 report data on the use of topical corticosteroid for the treatment of c-GvHD.…”

Section: Corticosteroid Creammentioning

confidence: 99%

“…46 Topical corticosteroids associated with topical CNIs appear to be effective in patients with localized or mild cutaneous c-GvHD. 41,47 No studies focusing the effects of topical corticosteroids on a-GvHD were found in this review.…”

Section: Corticosteroid Creammentioning

confidence: 99%

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Phototherapy and topical treatments for cutaneous graft vs. host disease in haematopoietic stem cell transplantation patients: a scoping review

Rostagno

Campanati

Mordini

et al. 2022

Acad Dermatol Venereol

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Skin is usually the first and most affected organ involved in graft-versus-host disease (GvHD), and treatment is still a clinical challenge. Although the need for skin-directed treatments such as physical treatments and topical medications are generally agreed on, what the gold standard treatment strategy should be remains open to debate. The aim of this scoping review was to synthesize the current knowledge on the topical and physical treatments of cutaneous GvHD in haematopoietic stem cell transplantation patients and to highlight the best evidence available so as to reduce the gap between 'what is known' and 'what is done' in the clinical practice. Twenty-eight studies were included in this qualitative synthesis. Photo-biomodulation with psoralen was not included in this review. Phototherapy (ultraviolet A or B or narrowband B) was the physical treatment most described in the literature in both acute GvHD and chronic GvHD. Topical calcineurin inhibitors such as tacrolimus ointment and pimecrolimus cream as well as corticosteroid creams such as clobetasol and triamcinolone are mainly used in case of chronic GvHD. In all of the studies included in the review, topical treatments were always associated with systemic therapy. None of the topical interventions identified in our review provided strong evidence supporting its use, and the topical approaches seemed to have an adjuvant role in the treatment of cutaneous GvHD.

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Hautmanifestationen der akuten und chronischen Graft-versus-host-Erkrankung nach allogener Stammzelltransplantation

Ziemer

Dumann

2020

Hautarzt

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Cutaneous Chronic Graft Versus Host Disease Following Allogeneic Haematopoietic Stem Cell Transplantation in Children: A Retrospective Study

Cited by 4 publications

References 17 publications

Association of recipient and donor interleukin 6 polymorphisms 174 and 597 with outcome after allogeneic hematopoietic stem cell transplantation in children

Association of recipient and donor interleukin 6 polymorphisms 174 and 597 with outcome after allogeneic hematopoietic stem cell transplantation in children

Phototherapy and topical treatments for cutaneous graft vs. host disease in haematopoietic stem cell transplantation patients: a scoping review

Hautmanifestationen der akuten und chronischen Graft-versus-host-Erkrankung nach allogener Stammzelltransplantation

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