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Autologous graft-versus-host disease in a child with stage IV neuroblastoma

Authors :
Michael D. Ioffreda
Sarah A. Basak
Jessica Kaffenberger
Source :
Pediatric dermatology. 32(2)
Publication Year :
2015

Abstract

Graft-versus-host disease (GVHD) is an underappreciated complication of autologous hematopoietic stem cell transplantation (AHSCT) that can affect the skin, gastrointestinal tract, and liver. The development of this rare condition is probably due to an impairment of immunologic tolerance that can occur spontaneously through T-cell dysregulation, possibly from intensive conditioning chemotherapy regimens, or intentionally through administration of cyclosporine in the hopes of promoting an antitumor response. We present the case of a 2-year-old boy with metastatic neuroblastoma who spontaneously developed autologous GVHD after AHSCT. Severe pruritus and an inability to taper his oral steroids without a disease flare marked his disease. Eventually partial relief was achieved with initiation of cyclosporine and a strict soak and smear protocol using topical triamcinolone 0.1% ointment.

Details

ISSN :
15251470
Volume :
32
Issue :
2
Database :
OpenAIRE
Journal :
Pediatric dermatology
Accession number :
edsair.doi.dedup.....33400781a8a199bc72973cb10132e0ff