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Tan WH, Ho A, Kadir HA, Zin TK, Jordan HCC, Lee HY, Pang SM, Yeo YW, Choo KJL, Oh CC. Incidence of cutaneous graft-versus-host disease in a Singapore academic medical centre - A retrospective cohort study. Australas J Dermatol 2023; 64:e26-e33. [PMID: 36645420 DOI: 10.1111/ajd.13980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 12/14/2022] [Accepted: 01/04/2023] [Indexed: 01/17/2023]
Abstract
BACKGROUND Cutaneous graft-versus-host disease (GVHD) is common in allogeneic haematopoietic stem cell transplantation. HLA mismatch is the most significant determinant of GVHD. Our study aimed to compare the incidence of cutaneous GVHD haploidentical (Haplo) and matched donors in an Asian population. METHODS Retrospective cohort study of the 2015-2019 bone marrow transplant registry was conducted in a transplant centre. We compared the incidence of cutaneous GVHD in Haplo with allogeneic matched unrelated donor (MUD) and matched-sibling donor (MSD) transplant recipients. Secondary objectives include acute and chronic GVHD incidence, dermatology referrals, and histological findings. RESULTS One hundred and seventy-nine out of 203 cases were reviewed; 17 (9.5%) Haplo, 80 (44.7%) MUDs and 82 (45.8%) MSDs. The median follow-up for Haplo, MUD and MSD was 15.2, 34.2 and 35.7 months, respectively. Haplo had a higher cumulative incidence of cutaneous GVHD than MUD and MSD (p = 0.053). Chronic GVHD was only reported in MSD. The most common histology was vacuolar interface changes (13 [44.8%]) with a wide range of onset post-transplant (19-456 days). CONCLUSIONS Haplo donors may have a higher GVHD incidence than MUD and MSD in our predominantly Asian cohort. This information may be helpful when counselling patients pre-transplant. Further prospective studies are required.
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Affiliation(s)
- Wen Hao Tan
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore
| | - Aloysius Ho
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Hanis Abdul Kadir
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
| | - That Khaing Zin
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore
| | | | - Haur Yueh Lee
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore
| | - Shiu Ming Pang
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore
| | - Yi Wei Yeo
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore
| | - Karen Jui Lin Choo
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore
| | - Choon Chiat Oh
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore
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Schifter M, Kwan J, Kang M, Kwong K, Lee A, Sukumar S, Lin MW. Unusual oral mucosal ulceration post allogenic hematopoietic stem cell transplantation. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:618-625. [PMID: 34764055 DOI: 10.1016/j.oooo.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 07/31/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Mark Schifter
- The Oral Immunology Clinic, Westmead Hospital, Westmead, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Department of Oral Medicine, Oral Pathology and Special Needs Dentistry, Westmead Centre for Oral Health, Westmead Hospital, Westmead, Australia.
| | - John Kwan
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Department of Haematology, Westmead Hospital, Westmead, Australia
| | - Michelle Kang
- The Oral Immunology Clinic, Westmead Hospital, Westmead, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Department of Oral Medicine, Oral Pathology and Special Needs Dentistry, Westmead Centre for Oral Health, Westmead Hospital, Westmead, Australia
| | - Kenelm Kwong
- The Oral Immunology Clinic, Westmead Hospital, Westmead, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Department of Oral Medicine, Oral Pathology and Special Needs Dentistry, Westmead Centre for Oral Health, Westmead Hospital, Westmead, Australia
| | - Adrian Lee
- The Oral Immunology Clinic, Westmead Hospital, Westmead, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Department of Immunopathology, ICPMR, NSW Health Pathology, Westmead Hospital, Westmead, Australia
| | - Suma Sukumar
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Department of Oral Medicine, Oral Pathology and Special Needs Dentistry, Westmead Centre for Oral Health, Westmead Hospital, Westmead, Australia
| | - Ming-Wei Lin
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Department of Immunopathology, ICPMR, NSW Health Pathology, Westmead Hospital, Westmead, Australia
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Singh RB, Marmalidou A, Amouzegar A, Chen Y, Dana R. Animal models of high-risk corneal transplantation: A comprehensive review. Exp Eye Res 2020; 198:108152. [PMID: 32721424 PMCID: PMC7508940 DOI: 10.1016/j.exer.2020.108152] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 07/05/2020] [Accepted: 07/15/2020] [Indexed: 12/16/2022]
Abstract
Over the past century, corneal transplantation has become the most commonly performed allogeneic solid tissue transplantation. Although more than 80% of the corneal transplantations have favorable outcomes, immune-mediated rejection continues to be the major cause of failure in well over 50% of graft recipients that have inflamed and vascularized host beds. Over the past two decades, the progress in our understanding of the immunological pathways that mediate graft rejection has aided in the development of novel therapeutic strategies. In order to successfully test the efficacy of these interventions, it is essential to model the immunological processes occurring as a consequence of corneal transplantation. Herein, we have comprehensively reviewed the established animal models used for replicating the immunopathological processes causing graft rejection in high-risk corneal transplantation settings. We have also discussed the practical and technical differences, as well as biological and immunological variations in different animal models.
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Affiliation(s)
- Rohan Bir Singh
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Anna Marmalidou
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Afsaneh Amouzegar
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA; Department of Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Yihe Chen
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Reza Dana
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
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