title: Autologous graft-versus-host disease in a child with stage IV neuroblastoma.
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.
authors.affiliation: Milton S. Hershey Pennsylvania State Medical Center, Hershey, Pennsylvania.
authors.forename: Jessica
authors.initials: J
authors.lastname: Kaffenberger
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Basak
authors.forename: Michael
authors.initials: M
authors.lastname: Ioffreda
mesh_terms: D000287:Administration, Topical; D064592:Autografts; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000473:pathology* / Q000628:therapy*; D011537:Pruritus / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D035583:Rare Diseases; D016896:Treatment Outcome; D014221:Triamcinolone / Q000627:therapeutic use
chemical_list: D014221:Triamcinolone; D016572:Cyclosporine