Generalized Vitiligo after Allogeneic Bone Marrow Transplantation

Cho, Sung Bin; Roh, Mi Ryung; Chung, Kee Yang; Lee, Kwang Hoon; Park, Yoon Kee

doi:10.1080/00015550410021556

Cited by 20 publications

(20 citation statements)

References 8 publications

(7 reference statements)

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“…Cho et al [27] hypothesized that GVHD may trigger an autoimmune cascade leading to the development of vitiligo. In our series, four patients were diagnosed with vitiligo after GVHD onset, all of whom received PBSC for HGP.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Complications after Hematopoietic Stem Cell Transplantation in Children with Nonmalignant Disorders

Khalil

Zaidman

Bergman

et al. 2014

The Scientific World Journal

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Background. Hematopoietic stem cell transplantation (HSCT) remains the only curative treatment for many nonmalignant disorders, such as autoimmune disorders, inborn metabolic disorders, hemoglobinopathies, and immunodeficiency disorders. Autoimmune complications (AICs) after HSCT, such as autoimmune cytopenias, autoimmune hepatitis, primary biliary cirrhosis, and autoimmune cutaneous manifestations, are still neither well defined nor characterized. Patients. Between 2000 and 2012, 92 patients (47 males, 45 females) were treated with HSCT in our hospital, 51 with congenital hemoglobinopathies, 19 with primary immunodeficiency disease, 10 with metabolic disorders, five with Fanconi anemia, three with aplastic anemia, and four with familial hemophagocytic lymphohistiocytosis. Results. Mean age at HSCT was 6.4 years (range, 0.2–32 years) and mean duration of followup after HSCT was 6.81 years (range, 1–11 years). Sixteen (17.4%) patients developed chronic GVHD and five (5.4%) showed sclerodermatous features. Five (5.4%) patients were diagnosed with scleroderma manifestations, six (6.5%) with vitiligo, six (6.5%) with autoimmune hemolytic anemia (AIHA), six (6.5%) with idiopathic thrombocytopenia, three (3.3%) with mild leucopenia, two (2.2%) with aplastic anemia, two (2.2%) (one boy, one girl) with autoimmune thyroid disease, and one (1.1%) with autoimmune hepatitis. Conclusions. It was concluded that AICs are clinically significant complications after HSCT that contribute to morbidity but not to mortality. AICs are more frequent after HSCT for metabolic disorders, and sclerodermatous GVHD is more significant in children who underwent allogeneic HSCT for hemoglobinopathies. The potential to identify risk factors for AICs could lead to less morbidity and mortality and to maintain the patient's quality of life.

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Section: Discussionmentioning

confidence: 99%

Autoimmune Complications after Hematopoietic Stem Cell Transplantation in Children with Nonmalignant Disorders

Khalil

Zaidman

Bergman

et al. 2014

The Scientific World Journal

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“…Premature graying of the hair and eyelashes and vitiligo-like leukoderma have been reported in association with chronic GVHD, and most of these cases are consequences of sclerodermatous lesions with poikilodermal aspects [13]. Vitiligo is very uncommon after AHCT [5,6,7,8,9,10,11]. The characteristics of the cases reported in the literature and ours are shown in tables 1 and 2.…”

Section: Discussionmentioning

confidence: 99%

“…The development of vitiligo after AHCT is explained by 4 possible reasons: (1) pretransplantation chemotherapy and radiotherapy may have rendered the melanocytes particularly susceptible to immune-mediated destruction [6, 14]; (2) chronic GVHD may have initiated an immune response directed selectively against the melanocyte destruction [7, 10, 11]; (3) the infusion of a larger number of lymphocytes after donor lymphocyte infusion may have also enhanced melanocyte destruction [8]; (4) adoptive passive transfer of vitiligo from the donor to the recipient after BMT might have resulted in the development of vitiligo [7,8,9]. …”

Section: Discussionmentioning

confidence: 99%

“…Vitiligo has been described in association with a variety of autoimmune diseases such as Graves’ disease, Hashimoto’s thyroiditis [2, 3], pernicious anemia [3], Addison’s disease [3], systemic lupus erythematosus [3] and alopecia areata [4]. Alternatively, autoimmune processes after allogeneic hematopoietic cell transplantation (AHCT) could occur but vitiligo-like total leukoderma [5] and vitiligo are not common complications of AHCT [6,7,8,9,10,11]. The reported cases occur early after bone marrow transplantation (BMT) and are usually accompanied by severe graft-versus-host disease (GVHD).…”

Section: Introductionmentioning

confidence: 99%

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Vitiligo after Hematopoietic Cell Transplantation: Six Cases and Review of the Literature

et al. 2008

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Aim: To investigate the prevalence and clinical characteristics of vitiligo after allogeneic hematopoietic cell transplantation (AHCT). Methods: The development of vitiligo was analyzed among 421 patients who underwent AHCT in Ibni Sina Hospital (University of Ankara) between 1988 and 2004. Results: Among 421 patients, we describe 6 with generalized vitiligo occurring after AHCT for chronic myelogenous leukemia. Five of them had severe chronic graft-versus-host disease (GVHD). Vitiligo was accompanied by alopecia areata and acquired ichthyosis in 2 patients with GVHD. Conclusion: Melanocyte destruction caused by the autoimmune reactions triggered by chronic GVHD as well as a genetic predisposition might have played a role in the development of vitiligo in our patients. These data support the hypothesis that vitiligo is an autoimmune entity.

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“…The development of GVHD is thought to involve damage to the thymus and impairment of immune selectivity, thus GVHD could act as a triggering factor for the appearance of autoantibodies and autoimmune disease 5 . There have been several case reports of vitiligo, which is considered a disease of autoimmunity against melanocytes, occurring after allogeneic BMT complicated by GVHD 2–4 . These cases suggest GVHD could trigger an immune response directed against melanocytes.…”

mentioning

confidence: 99%