THE EYE IN BONE-MARROW TRANSPLANTATION .3. CONJUNCTIVAL GRAFT-VS-HOST DISEASE
THE EYE IN BONE-MARROW TRANSPLANTATION .3. CONJUNCTIVAL GRAFT-VS-HOST DISEASE
复制标题
DOI：
10.1001/archopht.1989.01070020413046
复制
发表时间：
1989-09-01
影响因子：
--
通讯作者：
SARAL, R
中科院分区：
文献类型：
--
作者：
JABS, DA;WINGARD, J;SARAL, R
在接受异基因骨髓移植（BMT）的263例患者中，24例患者发生了移植物抗宿主病（GVHD）的结膜受累。在每种情况下，出现了代表结膜GVHD的明显结膜炎。在19例（79%）中，结膜GVHD表现为由于结膜上皮丢失而形成的假膜;在这些病例中，4例角膜上皮也丢失。19例患者发生这种特征与急性GVHD相关，这些患者的死亡率为89.5%。Kaplan-Meier生存分析显示，与所有骨髓移植受者和所有GVHD患者相比，结膜受累患者的生存率降低。然而，生存率与严重系统性GVHD患者（总体II期至IV期）相似。5例患者发生结膜移植物抗宿主病与慢性移植物抗宿主病相关，均为重度慢性移植物抗宿主病。这5名慢性GVHD患者中有4人随后死亡。GVHD累及结膜是一种独特的临床表现，是GVHD严重全身受累的标志。提出了一个眼部受累的临床分期系统。
Of a series of 263 patients undergoing allogeneic bone marrow transplantation (BMT), 24 patients developed conjunctival involvement by graft-vs-host disease (GVHD). In each case, a distinct-appearing conjunctivitis developed that represented GVHD of the conjunctiva. In 19 cases (79%), conjunctival GVHD presented with pseudomembrane formation due to loss of the conjunctival epithelium; in 4 of these cases, the corneal epithelium was lost as well. Nineteen patients developed this feature in association with acute GVHD, and mortality among these patients was 89.5%. Kaplan-Meier analysis of survival demonstrated a decreased survival of patients with conjunctival involvement compared with all marrow transplant recipients and compared with all patients with GVHD. However, survival was similar to that seen in patients with severe systemic GVHD (overall stages II through IV). Five patients developed conunctival GVHD in association with chronic GVHD, and all had severe chronic GVHD. Four of these five with chronic GVHD subsequently died. Conjunctival involvement by GVHD represents a distinct clinical finding and is a marker for severe systemic involvement by GVHD. A clinical staging system for occular involvemnt was formulated.