Ocular chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation in an Italian referral center

Ocul Surf. 2018 Jul;16(3):314-321. doi: 10.1016/j.jtos.2018.04.001. Epub 2018 Apr 4.

Abstract

Purpose: This study aimed to assess the prevalence and clinical manifestations of ocular graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

Methods: 269 patients who received allo-HSCT for hematologic malignancies were evaluated between December 2013 and April 2017 in this prospective observational study. Subjects underwent ophthalmologic examination at 6, 12 and 24 months after allo-HSCT. We evaluated the ophthalmologic and hematological data using the NIH consensus criteria definition and the International Chronic Ocular GVHD Consensus Group scoring systems.

Results: According to NIH consensus criteria definition, ocular GVHD developed in 46.1%, 51.9% and 54.7% of patients at the follow-up visits. According to the International Chronic Ocular GVHD Consensus Group, ocular GVHD developed in 41.3%, 47.7% and 51.9% of patients at the follow-up visits. We found a strong association between the presence of systemic GVHD and the development of chronic ocular GVHD throughout the entire follow-up period. Weaker associations were found between the presence of a female donor, matched related donor, conjunctival hyperemia and conjunctival fibrosis.

Conclusions: More than 50% of subjects develop chronic ocular GVHD after allo-HSCT. The presence of active systemic GVHD, female donor and matched related donor are associated with ocular GVHD development.

Keywords: Dry eye disease; Hematopoietic stem cell transplantation; Ocular graft-versus-host disease.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Conjunctiva / pathology
  • Female
  • Graft vs Host Disease* / epidemiology
  • Graft vs Host Disease* / pathology
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Young Adult