Retrospective analyzing of chronic cutaneous graft-versus-host disease in patient undergoing allogeneic hematopoietic stem cell transplantation which has hematologic malignancy

The aim of this study was to investigate the frequency, time, concomitant factors, clinical involvement, treatments and response rates, mortality rates and causes of patients with chronic cutaneous graft-versus-host disease. Between June 2011 and June 2018, 81 patients with hematological malignancy who underwent allogeneic hematopoietic stem cell transplantation in Uludağ University, School of Medicine, Internal Medicine Department, Bone Marrow Transplant Unit Of Hematology Division, were retrospectively analyzed. Gender, primary disease, age of transplantation, tissue adaptation, gender compliance between the transponder, CD34(+) stem cell source and amount, acute and chronic graft-versus-host disease rates, chronic graft-versus-host disease development times, concomitant factors, score, involvement, treatment, treatment duration, response rates, recurrence, mortality rates, causes of cutaneous chronic graft-versus-host disease were evaluated. 44% of the patients had acute graft-versus-host disease, 39% had chronic graft-versus-host disease, 22% had both developed, and 40,6% of patients with chronic graft-versus-host disease developed cutaneous chronic graft-versus-host disease, and the mean duration of development was 5,6 months. Acute graft-versus-host disease was found to be a risk factor in the development of cutaneous chronic graft-versus-host disease (p<0,05); gender, age, primary disease, donor-recipient sex compliance, CD34 (+) stem cell amount was not detected as a risk factor in the development of cutaneous chronic graft-versus-host disease (p>0,05). It was seen that 92,3% of the patients had more than one organ involvement and 92,3% of the cases had lichenoid involvement. The first-line treatment was corticosteroid treatment, and phototherapy, extracorporeal photopheresis, mycophenolate mofetil, methotrexate and topical tacrolimus treatments were chosen for the top-line treatments. Complete response was 38%, partial response was 61,5%. Recurrence was 15,3%, and in 76,9% of the patients died. There was no significant decrease in recurrence in chronic graft-versus-host patients (p>0,05). The cause of death was 60% sepsis. In conclusion, although the data on cutaneous chronic graft-versus-host disease are similar to those in the present study, the retrospective nature of the study, the diversity of the treatment, and the low number of patients may affect the disease rate, clinical characteristics, and results of the study. Prospective large-scale studies are necessary to define the treatment algorithm. Keywords: Allogeneic stem cell transplantation, chronic graft versus host disease, cutaneous graft versus host disease.