Sclerodermatous graft-versus-host disease: clinical spectrum and therapeutic challenges

White, Jennifer; Creamer, Daniel; Vivier, Anthony du; Pagliuca, Antonio; Ho, A Y L; Devereux, Stephen; Salisbury, Jonathan R.; Mufti, Ghulam J.

doi:10.1111/j.1365-2133.2007.07827.x

Cited by 42 publications

(28 citation statements)

References 34 publications

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“…For chronic GvHD, PUVA treatment was reported to be more effective with the lichenoid form of the disease; with improvement in sclerotic GvHD reported in some instances. 5,46 However it was also reported that after the PUVA treatment was ceased the lesions returned. 40 UVA1 Three studies were identified that utilised UVA1 in the treatment of chronic cutaneous GvHD.…”

Section: Chronic Gvhdmentioning

confidence: 93%

Phototherapy for the treatment of cutaneous graft versus host disease

Garbutcheon‐Singh

Fernández‐Peñas

2014

Aust J Dermatology

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Graft versus host disease (GvHD) occurs in half the patients who receive allogenic haematopoietic stem cell transplantation and is a major contributor for the morbidity and mortality in these patients. Immunosuppressant therapy cannot suppress all the manifestations of GvHD and new ways of treating the condition are needed. The focus of this review is the treatment of cutaneous GvHD through phototherapy. Of the six acute and ten chronic cutaneous GvHD case series examined the overall trend was that phototherapy was able to reduce the presence of cutaneous lesions of GvHD and, as a consequence, steroid use could be reduced. This provides a positive outlook for phototherapy as a treatment for cutaneous GvHD but there is a need for future studies to include larger numbers of patients in order to obtain more data.

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Section: Chronic Gvhdmentioning

confidence: 93%

Phototherapy for the treatment of cutaneous graft versus host disease

Garbutcheon‐Singh

Fernández‐Peñas

2014

Aust J Dermatology

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“…However, the clinical spectrum of cGVHD is broad [25,26] and it can include poikiloderma, xerosis, annular scleroderma-like lesions, keratosis pilaris-like lesions, psoriasiform lesiones, deep sclerotic features, eccema-like lesions, acral erythema, fasciitis, morphea-like superficial sclerotic features, and/or lichen sclerosus-like [1,7,10,24,27].…”

Section: Prevention and Treatmentmentioning

confidence: 99%

“…Sclerodermatous GVHD is characterized by hypo or hyperpigmented thickened, tight, indurated and fragile skin which is often associated with poor wound-healing, inadequate lymphatic drainage, skin ulcers from minor trauma, contractures and limited joint mobility [10,24,25]. Characteristically, these lesions tend to appear on sites of minor skin trauma or pressure (waistband line, brassiere line) or on sites of previous skin damage (such as old scars or site of a previous herpes zoster infection) [10].…”

Section: Prevention and Treatmentmentioning

confidence: 99%

Skin Signs of Graft Versus Host Disease

Sousa¹,

Herskovitz²

2013

J Bone Marrow Res

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Graft-versus-host disease is a common complication of allogenic hematopoietic cell transplantation and less frequently of solid organ transplantation. The skin is one of the initial and main organs affected, and as such, recognizing the dermatologic manifestations allows early diagnosis and treatment.In this article we aim to describe the cutaneous manifestations of graft-versus-host disease so that non-dermatologist is able to recognize the early signs of this complication.

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“…Due to the paucity of microarray data for standalone meta-analysis of cGVHD, we used similarities in systemic responses between cGVHD and systemic sclerosis (SSc) to link their microarray datasets [5,6]. The similarity in systemic responses between cGVHD and SSc was demonstrated in the experimental settings and was attributed to the excessive activation of T and B cells in both conditions [7].…”

Section: Introductionmentioning

confidence: 99%

Combined meta-analysis of systemic effects of allogeneic stem cell transplantation and systemic sclerosis

et al. 2014

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BackgroundChronic graft-versus-host disease (cGVHD) is a major factor of morbidity and mortality for allogeneic stem cell transplantation (aSCT). The skin and internal organ involvement is the most common systemic complication of cGVHD and closely resembles systemic sclerosis (SSc). Circulating lymphocytes characterize the autoimmune nature of both conditions. Therefore we hypothesized that the common clinical manifestation (systemic organ and skin injury) and the common underlying players (lymphocytes) justify the combined meta-analysis of these diseases.ResultsThe aSCT and SSc datasets were uploaded from Gene Expression Omnibus (GEO), a public functional genomics data repository. The available microarray studies of peripheral blood mononuclear cells (PBMCs) and isolated lymphocytes were limited to well established microarray platforms (Affymetrix, Agilent, Canvac, and Illumina) and experimental settings with ≥10 patients per group. The resulting pools of data were merged by unique gene identifier and analyzed by the expression genome-wide association studies (eGWAS) coupled with the subtraction of the cGVHD+ and cGVHD− molecular signatures. The eGWAS was applied to 47 and 50 lymphocyte profiles from aSCT and SSc patients, respectively. The identified 35 candidates were represented by 8 known cGVHD genes (including CXCR4, LTBR and PML) and 28 new candidate genes (including SEPX1 and DNJGB1). The further mutual subtraction of cGVHD+ and cGVHD− candidates and pathway analysis identified a list of 25 genes. Seven of these genes belong to the fibroblast development and function pathway, consisting of the well known cGVHD genes CCND1, JUN, and FOS, and the new molecular targets MMP2, FOSB, TNFAIP8, and DUSP1. These genes become primary candidates for a potential link of systemic effects of cGVHD and SSc.ConclusionsWe designed a new approach for meta-analysis by combining data from different diseases using common clinical manifestation as a linker. This allowed us to power up the insufficient standalone meta-analysis of aSCT microarray studies, by adding SSc samples to the data pool. This new method has successfully identified novel molecular targets for systemic effects of both aSCT and SSc. We believe that this approach is generalizable and can be applied to an array of diseases with common clinical manifestations.

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Sclerodermatous graft-versus-host disease: clinical spectrum and therapeutic challenges

Cited by 42 publications

References 34 publications

Phototherapy for the treatment of cutaneous graft versus host disease

Phototherapy for the treatment of cutaneous graft versus host disease

Skin Signs of Graft Versus Host Disease

Combined meta-analysis of systemic effects of allogeneic stem cell transplantation and systemic sclerosis

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