Lichen planus-like histopathologic characteristics in the cutaneous graft-vs-host reaction

Prognostic significance independent of time course after allogenic bone marrow transplantation

Thomas D. Horn, Marianna L. Zahurak, Debra Atkins, Alvin Jr Solomon, Georgia B. Vogelsang

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: The discrimination between acute and chronic graft-vs-host disease (GVHD) after allogeneic bone marrow transplantation (BMT) is important because the treatment regimens and prognosis differ. Objectives: To identify whether accepted histopathologic criteria of a graft-vs-host reaction (GVHR) alone or in combination accurately reflect clinical phase of disease, to correlate patterns with clinical outcome, and to identify any concordance between inflammation and epidermal changes of a GVHR. Design: Skin biopsy specimens were analyzed according to histologically defined standards. Setting: This study was performed in a tertiary care hospital. Patients: One hundred seventy-three skin biopsy specimens (10 days before to 1326 days after BMT) from 83 patients undergoing allogeneic BMT for various malignant neoplasms were selected for study. A consecutive 12-month sample was used. Main Outcome Measures: The main measures in this study were statistical correlations between histopathologic findings and time after BMT, the outcome of BMT, and the correlations between selected histopathologic criteria. Results: Fully evolved histologic features of chronic lichenoid GVHR in the specimens occurred across a wide time range (33-832 days after BMT) and were associated with a 5.6-fold increased risk for death (P=.02) from GVHD. Histologic features of acute GVHR in the specimens also occurred across a wide time range (14-481 days after BMT) and were associated with a 2.2-fold increased risk for death: this finding was not statistically significant (P=.11). Inflammation of the upper dermis was significantly associated with acanthosis and epidermal cell necrosis (P

Original languageEnglish (US)
Pages (from-to)961-965
Number of pages5
JournalArchives of Dermatology
Volume133
Issue number8
StatePublished - 1997
Externally publishedYes

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Graft vs Host Reaction
Lichen Planus
Homologous Transplantation
Bone Marrow Transplantation
Skin
Graft vs Host Disease
Inflammation
Biopsy
Tertiary Healthcare
Dermis
Tertiary Care Centers
Necrosis
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Dermatology

Cite this

Lichen planus-like histopathologic characteristics in the cutaneous graft-vs-host reaction : Prognostic significance independent of time course after allogenic bone marrow transplantation. / Horn, Thomas D.; Zahurak, Marianna L.; Atkins, Debra; Solomon, Alvin Jr; Vogelsang, Georgia B.

In: Archives of Dermatology, Vol. 133, No. 8, 1997, p. 961-965.

Research output: Contribution to journalArticle

Horn, Thomas D. ; Zahurak, Marianna L. ; Atkins, Debra ; Solomon, Alvin Jr ; Vogelsang, Georgia B. / Lichen planus-like histopathologic characteristics in the cutaneous graft-vs-host reaction : Prognostic significance independent of time course after allogenic bone marrow transplantation. In: Archives of Dermatology. 1997 ; Vol. 133, No. 8. pp. 961-965.
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