Ophthalmological aspects in allogenic bone marrow transplantation: Sjögren-like syndrome in graft-versus-host disease.
OBJECTIVE
A major complication of allogenic bone marrow transplantation (BMT) is graft-versus-host disease (GVHD), characterized principally by involvement of the eyes, producing a Sjögren-like syndrome (SLS). This study assessed the predictive role of the eye involvement in the onset of GVHD.


METHODS
Thirty-five patients transplanted for hematological malignancies were routinely examined for ocular manifestation of dry eye. Examination includes the Schirmer I test, break-up time, Lissamine Green staining, fluorescein test, lactoferrin test and impression cytology. A threshold was established for quantitative analysis of SLS.


RESULTS
Fifteen of 35 patients (40%) developed SLS during long-term follow-up. Ten of these (77%) developed acute or chronic GVHD.


CONCLUSIONS
The possible etiology of SLS includes three factors: total body irradiation, ocular toxicity of chemotherapy and GVHD. A correlation was found between poor-prognosis GVHD and the occurrence of SLS.
Mencucci
R
R
1st Eye Clinic, University of Firenze, Italy.
Rossi Ferrini
C
C
Bosi
A
A
Volpe
R
R
Guidi
S
S
Salvi
G
G
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003228:Conjunctiva / Q000473:pathology; D003315:Cornea / Q000473:pathology; D015352:Dry Eye Syndromes / Q000209:etiology / Q000473:pathology; D005260:Female; D019793:Fluorescein; D005452:Fluoresceins; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology* / Q000473:pathology; D019337:Hematologic Neoplasms / Q000628:therapy; D006801:Humans; D007781:Lactoferrin / Q000378:metabolism; D008086:Lissamine Green Dyes; D008297:Male; D012859:Sjogren's Syndrome / Q000209:etiology* / Q000473:pathology; D013666:Tears / Q000166:cytology / Q000378:metabolism; D014184:Transplantation, Homologous
D005452:Fluoresceins; D008086:Lissamine Green Dyes; D007781:Lactoferrin; D019793:Fluorescein