Source:http://linkedlifedata.com/resource/pubmed/id/21106223
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
2
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| pubmed:dateCreated |
2011-1-17
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| pubmed:abstractText |
Reduced-intensity conditioning regimens have reshaped the clinical presentation of graft-versus-host disease after hematopoietic stem cell transplants. However, histopathologic features of graft-versus-host disease following reduced-intensity conditioning regimens have not been fully characterized. In a series of 112 biopsies (skin, n = 60; gastrointestinal [GI] tract, n = 44; liver, n = 8), we described the morphologic profile of graft-versus-host disease following reduced-intensity conditioning and investigated whether histopathologic changes of graft-versus-host disease following reduced-intensity conditioning have a diagnostic and/or prognostic value. Forty-four patients (49.5%) experienced acute graft-versus-host disease, 2 (2.2%) late-onset acute graft-versus-host disease (grade I, n = 13; grade II-IV, n = 33), 24 (27.0%) chronic graft-versus-host disease (de novo n = 12, progressive n = 12) and 19 (21.3%) overlap syndrome. In the skin, we observed: (i) phase-nonspecific changes, such as acute graft-versus-host disease features in chronic graft-versus-host disease patients (n = 4/24; 16.6%), (ii) subtle alterations such as superficial fibrosis in widened dermal papillae (n = 8), in acute graft-versus-host disease/late-onset graft-versus-host disease (n = 6/46; 13.0%) or chronic graft-versus-host disease (n = 2/24, 8.3%) patients, and (iii) features of chronic and acute graft-versus-host disease coexisting in the same specimen in overlap syndrome (n = 3/19; 15.7%). In the GI tract, we did not demonstrate peculiar features differing from those commonly observed in the myeloablative setting. By univariate analysis, a reduced overall survival was associated with graft-versus-host disease type (chronic graft-versus-host disease P = .006, acute graft-versus-host disease P = .03), older age (P = .04), and histopathologic diagnosis of "consistent with" + definite graft-versus-host disease (P = .02). Histopathologic diagnosis retained an independent prognostic value by multivariate analysis (P = .01). The present study indicates that pathologists should be aware of the peculiar morphologic changes of cutaneous graft-versus-host disease following reduced-intensity conditioning and further recommends histopathology in the diagnostic workup of graft-versus-host disease in patients undergoing reduced-intensity conditioning regimen.
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:status |
MEDLINE
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| pubmed:month |
Feb
|
| pubmed:issn |
1532-8392
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| pubmed:author |
pubmed-author:AlbarelloLucaL,
pubmed-author:AvelliniClaudioC,
pubmed-author:BenemeiSilviaS,
pubmed-author:BonoldiEmanuelaE,
pubmed-author:BosiAlbertoA,
pubmed-author:CasiniMarcoM,
pubmed-author:CesinaroAnna MariaAM,
pubmed-author:CiceriFabioF,
pubmed-author:ColombettiVitoV,
pubmed-author:CominCamilla EvaCE,
pubmed-author:DonelliAmedeaA,
pubmed-author:FondiCristinaC,
pubmed-author:FortunatoMirellaM,
pubmed-author:FratoniStefanoS,
pubmed-author:GuidiStefanoS,
pubmed-author:LapiFrancescoF,
pubmed-author:MassiDanielaD,
pubmed-author:MesseriniLucaL,
pubmed-author:MeugnierMM,
pubmed-author:MiloneGiuseppeG,
pubmed-author:NegriGiovanniG,
pubmed-author:NozzoliChiaraC,
pubmed-author:PeccatoriFedro AlessandroFA,
pubmed-author:PonzoniMaurilioM,
pubmed-author:RafanielloPaolaP,
pubmed-author:RaimondiRobertoR,
pubmed-author:RapezziDavideD,
pubmed-author:SalomoneEdvigeE,
pubmed-author:SantucciMarcoM,
pubmed-author:TendasAndreaA,
pubmed-author:VillariLoredanaL
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| pubmed:copyrightInfo |
Copyright © 2011 Elsevier Inc. All rights reserved.
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| pubmed:issnType |
Electronic
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| pubmed:volume |
42
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| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
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| pubmed:pagination |
254-68
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| pubmed:meshHeading |
pubmed-meshheading:21106223-Adult,
pubmed-meshheading:21106223-Aged,
pubmed-meshheading:21106223-Bone Marrow Transplantation,
pubmed-meshheading:21106223-Female,
pubmed-meshheading:21106223-Graft vs Host Disease,
pubmed-meshheading:21106223-Hematopoietic Stem Cell Transplantation,
pubmed-meshheading:21106223-Humans,
pubmed-meshheading:21106223-Male,
pubmed-meshheading:21106223-Middle Aged,
pubmed-meshheading:21106223-Prognosis,
pubmed-meshheading:21106223-Survival Rate,
pubmed-meshheading:21106223-Transplantation Conditioning,
pubmed-meshheading:21106223-Young Adult
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| pubmed:year |
2011
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| pubmed:articleTitle |
The impact of histopathologic examination of graft-versus-host disease in the era of reduced-intensity conditioning regimen: a study from the Gruppo Italiano Trapianto di Midollo Osseo.
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| pubmed:affiliation |
Division of Anatomic Pathology, Department of Critical Care Medicine and Surgery, University of Florence, Italy. daniela.massi@unifi.it
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| pubmed:publicationType |
Journal Article,
Research Support, Non-U.S. Gov't
|