Impact of macrophage infiltration of skin lesions on survival after allogeneic stem cell transplantation: a clue to refractory graft-versus-host disease.
We retrospectively reviewed 104 biopsy specimens of previously untreated skin acute graft-versus-host disease (GVHD) within 100 days after allogeneic stem cell transplantation, and analyzed the relationship between types of infiltrating cells and clinical outcomes. Counting the total number of CD8(+) T cells, CD163(+) macrophages, and CD1a(+) dendritic cells in 4 fields under original magnification x200, the infiltration of more than 200 cells of CD163(+) macrophages (many macrophages [MM]) was the only significant predictor for refractory GHVD (odds ratio, 3.79; 95% confidence interval, 1.22-11.8; P = .02). In 46 patients given steroid treatments, MM was the only significant predictor for refractory acute GVHD (odds ratio, 5.05; 95% confidence interval, 1.19-21.3; P = .03). Overall survival of patients with MM was significantly lower than that of those with an infiltration of less than 200 cells of CD163(+) macrophages. Macrophage infiltration of skin lesions could be a significant predictive factor for refractory GVHD and a poor prognosis.
Nishiwaki
Satoshi
S
Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
Terakura
Seitaro
S
Ito
Masafumi
M
Goto
Tatsunori
T
Seto
Aika
A
Watanabe
Keisuke
K
Yanagisawa
Mayumi
M
Imahashi
Nobuhiko
N
Tsukamoto
Shokichi
S
Shimba
Makoto
M
Ozawa
Yukiyasu
Y
Miyamura
Koichi
K
D000328:Adult; D003713:Dendritic Cells / Q000276:immunology / Q000473:pathology; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality*; D006801:Humans; D008264:Macrophages / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012871:Skin Diseases / Q000276:immunology / Q000473:pathology*; D033581:Stem Cell Transplantation; D015996:Survival Rate; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology; D014184:Transplantation, Homologous; D055815:Young Adult