Original Paper

Partial Reconstitution of Cutaneous Microvessels in Long-Term Survivors after Allogeneic Bone Marrow Transplantation
P. Haeusermann^a, E. Kump^{a, b}, A. Rovó^c, A. Tichelli^c, P. Itin^a, A. Gratwohl^c, B.C. Biedermann^{b, d}

Departments of
^aDermatology and
^bBiomedicine, and
^cDivision of Hematology, Department of Medicine, University Hospital Basel, Basel, and
^dUniversity Department of Medicine, Kantonsspital Bruderholz, Bruderholz, Switzerland

Address of Corresponding Author

Dermatology 2009;219:32-41 (DOI: 10.1159/000216934)

  Key Words

• Graft-versus-host disease
• Allogeneic hematopoietic stem cell transplantation
• Long-term survivors

  Abstract

Background: Graft-versus-host disease (GVHD) is a major complication after allogeneic hematopoietic stem cell transplantation (HSCT) and skin is involved in acute and chronic disease. Immune-mediated vessel attack and subsequent microvessel loss have been observed in skin of patients with chronic GVHD. Objectives: To test whether long-term survivors (LTS) after allogeneic HSCT without cutaneous GVHD show signs of persistent vascular remodeling. Methods: Microvessels in skin biopsies were investigated in a cohort of 32 LTS with a median follow-up of 17 years (range 11–26). Five were currently classified as having chronic GVHD other than skin involvement. Results: LTS showed no significant difference in median microvessel density and relative vessel size distribution pattern compared to healthy controls. Past experience of GVHD and current status of chronic GVHD other than skin involvement had no impact on vessel density. In contrast, recipients with chronic cutaneous GVHD of sclerotic type and patients with lichen sclerosus have significant microvessel loss in the upper dermis. Conclusion: The complex therapy of allogeneic HSCT had no sustained effect on the microvascular architecture of LTS when clinicopathological evidence of cutaneous GVHD is absent. Microvascular remodeling as observed during chronic GVHD recovers completely after resolution of chronic cutaneous GVHD.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Dr. Peter Haeusermann, MD
Department of Dermatology, University Hospital Basel
Petersgraben 4
CH–4031 Basel (Switzerland)
Tel. +41 61 265 25 25, Fax +41 61 265 48 85, E-Mail phaeusermann@uhbs.ch

  Article Information

P. Haeusermann and E. Kump contributed equally to this work.

Received: December 12, 2008
Accepted: February 19, 2009
Published online: April 29, 2009
Number of Print Pages : 10
Number of Figures : 4, Number of Tables : 2, Number of References : 23