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. 1988 Feb;41(2):148–154. doi: 10.1136/jcp.41.2.148

Histological features of skin and rectal biopsy specimens after autologous and allogeneic bone marrow transplantation.

L Sviland 1, A D Pearson 1, E J Eastham 1, P J Hamilton 1, S J Proctor 1, A J Malcolm 1
PMCID: PMC1141369  PMID: 3280605

Abstract

The histological appearances of skin and rectal biopsy specimens were studied in 31 bone marrow transplant recipients (13 autologous, 18 allogeneic) before transplant, at 28 days, at six months, and as soon as graft versus host disease (GVHD) was clinically suspected. Grades I and II skin changes were commonly seen in patients before transplant and in the autologous group after transplant, as well as in most of the allogeneic recipients with suspected GVHD. Epidermal lymphocytic infiltration was seen only in allogeneic recipients, with clinical GVHD following transplant, but this was not a consistent finding and no other histological features were seen which would distinguish early GVHD from changes caused by cytotoxic agents. Rectal biopsy specimens, however, were normal in patients before transplant and in autologous recipients at 28 days; single cell necrosis of crypt cells was seen only in six of 13 allogeneic recipients studied after transplant with clinical skin GVHD but no gastrointestinal symptoms. Skin changes greater than I and II are required for the histological diagnosis of GVHD. Rectal changes are more specific and may be present despite a lack of intestinal symptoms.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Atkinson K., Munro V., Vasak E., Biggs J. Mononuclear cell subpopulations in the skin defined by monoclonal antibodies after HLA-identical sibling marrow transplantation. Br J Dermatol. 1986 Feb;114(2):145–160. doi: 10.1111/j.1365-2133.1986.tb02793.x. [DOI] [PubMed] [Google Scholar]
  2. Barranger J. A. Marrow transplantation in genetic disease. N Engl J Med. 1984 Dec 20;311(25):1629–1631. doi: 10.1056/NEJM198412203112509. [DOI] [PubMed] [Google Scholar]
  3. Breathnach S. M., Katz S. I. Cell-mediated immunity in cutaneous disease. Hum Pathol. 1986 Feb;17(2):161–167. doi: 10.1016/s0046-8177(86)80289-1. [DOI] [PubMed] [Google Scholar]
  4. Elliott C. J., Sloane J. P., Sanderson K. V., Vincent M., Shepherd V., Powles R. The histological diagnosis of cutaneous graft versus host disease: relationship of skin changes to marrow purging and other clinical variables. Histopathology. 1987 Feb;11(2):145–155. doi: 10.1111/j.1365-2559.1987.tb02618.x. [DOI] [PubMed] [Google Scholar]
  5. Epstein R. J., McDonald G. B., Sale G. E., Shulman H. M., Thomas E. D. The diagnostic accuracy of the rectal biopsy in acute graft-versus-host disease: a prospective study of thirteen patients. Gastroenterology. 1980 Apr;78(4):764–771. [PubMed] [Google Scholar]
  6. Glucksberg H., Storb R., Fefer A., Buckner C. D., Neiman P. E., Clift R. A., Lerner K. G., Thomas E. D. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors. Transplantation. 1974 Oct;18(4):295–304. doi: 10.1097/00007890-197410000-00001. [DOI] [PubMed] [Google Scholar]
  7. Koss L. G. A light and electron microscopic study of the effects of a single dose of cyclophosphamide on various organs in the rat. I. The urinary bladder. Lab Invest. 1967 Jan;16(1):44–65. [PubMed] [Google Scholar]
  8. Lerner K. G., Kao G. F., Storb R., Buckner C. D., Clift R. A., Thomas E. D. Histopathology of graft-vs.-host reaction (GvHR) in human recipients of marrow from HL-A-matched sibling donors. Transplant Proc. 1974 Dec;6(4):367–371. [PubMed] [Google Scholar]
  9. Sale G. E., Lerner K. G., Barker E. A., Shulman H. M., Thomas E. D. The skin biopsy in the diagnosis of acute graft-versus-host disease in man. Am J Pathol. 1977 Dec;89(3):621–636. [PMC free article] [PubMed] [Google Scholar]
  10. Sale G. E., Shulman H. M., McDonald G. B., Thomas E. D. Gastrointestinal graft-versus-host disease in man. A clinicopathologic study of the rectal biopsy. Am J Surg Pathol. 1979 Aug;3(4):291–299. doi: 10.1097/00000478-197908000-00001. [DOI] [PubMed] [Google Scholar]
  11. Shulman H. M., Sale G. E., Lerner K. G., Barker E. A., Weiden P. L., Sullivan K., Gallucci B., Thomas E. D., Storb R. Chronic cutaneous graft-versus-host disease in man. Am J Pathol. 1978 Jun;91(3):545–570. [PMC free article] [PubMed] [Google Scholar]
  12. Snover D. C. Mucosal damage simulating acute graft-versus-host reaction in cytomegalovirus colitis. Transplantation. 1985 Jun;39(6):669–670. [PubMed] [Google Scholar]
  13. Storb R. Bone marrow transplantation for the treatment of hematologic malignancy and of aplastic anemia. Transplant Proc. 1981 Mar;13(1 Pt 1):221–226. [PubMed] [Google Scholar]
  14. Sullivan K. M., Parkman R. The pathophysiology and treatment of graft-versus-host disease. Clin Haematol. 1983 Oct;12(3):775–789. doi: 10.1016/s0308-2261(83)80010-1. [DOI] [PubMed] [Google Scholar]
  15. Woodruff J. M., Eltringham J. R., Casey H. W. Early secondary disease in the Rhesus monkey. I. A comparative histopathologic study. Lab Invest. 1969 Jun;20(6):499–511. [PubMed] [Google Scholar]

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