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Bone Marrow Transplant. 2018 Dec 7. doi: 10.1038/s41409-018-0340-0. [Epub ahead of print]

Ocular graft-versus-host disease after hematopoietic cell transplantation: Expert review from the Late Effects and Quality of Life Working Committee of the CIBMTR and Transplant Complications Working Party of the EBMT.

Author information

1
Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan. yinamoto@ncc.go.jp.
2
Department of Ophthalmology, Hospital Universitario Puerta de Hierro, Madrid, Spain.
3
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
4
Department of Ophthalmology, University of Campinas, Campinas, Brazil.
5
Department of Ophthalmology, San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
6
Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
7
Bone Marrow Transplantation Unit, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
8
Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St., Petersburg, FL, USA.
9
Shands HealthCare and University of Florida, Gainesville, FL, USA.
10
H. Lee Moffitt Cancer Center Cleveland, Cleveland, OH, USA.
11
Hackensack University Medical Center, Washington, DC, USA.
12
University Hospital of Leuven, Leuven, Belgium.
13
Division of Stem Cell Transplantation and Regenerative Medicine, Lucille Packard Children's Hospital, Stanford School of Medicine, Palo Alto, CA, USA.
14
Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy.
15
Simon Cancer Center, Indiana University, Indianapolis, IN, USA.
16
Department of Hematology Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO, USA.
17
Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
18
CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
19
Vanderbilt University Medical Center, Nashville, TN, USA.
20
Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, MA, USA.
21
Department of Clinical Neuroscience, Karolinska Institutet, St. Erik Eye Hospital, Stockholm, Sweden.
22
Utah Blood and Marrow Transplant Program Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
23
Rush University Medical Center, Chicago, IL, USA.
24
Department of Internal Medicine, Division of Haematology and Oncology, Charité University Medicine, Campus Rudolf Virchow, Berlin, Germany.
25
Lousiana State University Children's Hospital, New Orleans, LA, USA.
26
Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
27
Inselspital, Universitatsspital Bern, Bern, Switzerland.
28
Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA.
29
Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
30
Medical University of Warsaw, Warsaw, Poland.
31
Hematology Branch, Sarah Cannon BMT Program, Nashville, TN, USA.
32
University Hospital Puerta de Hierro, Madrid, Spain.
33
Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
34
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
35
Department of Ophthalmology, University Clinical Hospital Zagreb, Zagreb, Croatia.

Abstract

Ocular graft-versus-host disease (GVHD) occurs in more than half of patients who develop chronic GVHD after allogeneic hematopoietic cell transplantation (HCT), causing prolonged morbidity, which affects activities of daily living and quality of life. Here we provide an expert review of ocular GVHD in a collaboration between transplant physicians and ophthalmologists through the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and the Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation. Recent updates in ocular GVHD, regarding pathophysiology, preclinical models, risk factors, prevention, screening, diagnosis, response criteria, evaluation measures, and treatment are discussed in this review. Ocular GVHD has at least three biological processes: lacrimal gland dysfunction, meibomian gland dysfunction, and corneoconjunctival inflammation. Preclinical models have found several novel pathogenic mechanisms, including renin angiotensin system and endoplasmic reticulum stress signaling that can be targeted by therapeutic agents. Many studies have identified reliable tests for establishing diagnosis and response assessment of ocular GVHD. Efficacy of systemic and topical treatment for ocular GVHD is summarized. It is important for all health professionals taking care of HCT recipients to have adequate knowledge of ocular GVHD for optimal care.

PMID:
30531954
DOI:
10.1038/s41409-018-0340-0

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