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Credit: PLOS ONE
Results of a retrospective study have revealed factors that appear to increase the risk of vitiligo and alopecia areata (AA) in patients who develop chronic graft-vs-host disease (cGVHD) after a stem cell transplant.
Multivariable analysis suggested that a female donor to male recipient sex mismatch and positive test results for anticardiolipin immunoglobulin G (ACA-IgG) were both significantly associated with vitiligo and/or AA.
This research was published in JAMA Dermatology.
Edward W. Cowen, MD, of the National Cancer Institute in Bethesda, Maryland, and his colleagues conducted the study in 282 adult and pediatric patients with cGVHD.
Fifteen of the patients (5.3%) had vitiligo and/or AA. One patient had only AA, 1 had vitiligo and AA, and the rest had vitiligo alone. The median age of these patients at enrollment was 38 years (range, 9-69 years), and most were male (n=10).
Most patients had received a transplant to treat chronic myelogenous leukemia (n=5) or acute leukemia/myelodysplastic syndrome (n=5). Most patients (n=13) had an HLA-identical donor and received a peripheral blood stem cell transplant (n=9).
Eleven patients had concomitant skin cGVHD at the time of evaluation, and it was most often sclerotic-type cGVHD (n=9).
For the 5 vitiligo patients in whom the onset of skin depigmentation was documented, pigment changes occurred at a median of 41 months (range, 24-84) after transplant.
Depigmentation was classic periorbital, perioral, acrofacial involvement in 6 patients, generalized in 6 patients, and torso-predominant in 2 patients. Trichrome vitiligo was present in 3 patients, and poliosis occurred in 5 patients. In both AA patients, hair loss was localized to the scalp.
The researchers evaluated demographic, clinical, and laboratory data from these patients, and used univariate and multivariable logistic regression analyses to identify risk factors for vitiligo and AA.
Univariate analysis suggested the following factors were significantly associated with vitiligo and/or AA: female donor to male recipient sex mismatch (P=0.003), positive test results for ACA-IgG (P=0.03) or antiparietal antibody (P=0.049), elevated CD19 (P=0.045), and normal or elevated IgG (P=0.02).
However, only positive ACA-IgG results and female donor to male recipient mismatch retained significance in multivariable analysis (P=0.01 and P=0.003, respectively).
The researchers said additional studies are needed to clarify whether these risk factors can lead to a better understanding of the pathomechanisms of cGVHD. 
Credit: PLOS ONE
Results of a retrospective study have revealed factors that appear to increase the risk of vitiligo and alopecia areata (AA) in patients who develop chronic graft-vs-host disease (cGVHD) after a stem cell transplant.
Multivariable analysis suggested that a female donor to male recipient sex mismatch and positive test results for anticardiolipin immunoglobulin G (ACA-IgG) were both significantly associated with vitiligo and/or AA.
This research was published in JAMA Dermatology.
Edward W. Cowen, MD, of the National Cancer Institute in Bethesda, Maryland, and his colleagues conducted the study in 282 adult and pediatric patients with cGVHD.
Fifteen of the patients (5.3%) had vitiligo and/or AA. One patient had only AA, 1 had vitiligo and AA, and the rest had vitiligo alone. The median age of these patients at enrollment was 38 years (range, 9-69 years), and most were male (n=10).
Most patients had received a transplant to treat chronic myelogenous leukemia (n=5) or acute leukemia/myelodysplastic syndrome (n=5). Most patients (n=13) had an HLA-identical donor and received a peripheral blood stem cell transplant (n=9).
Eleven patients had concomitant skin cGVHD at the time of evaluation, and it was most often sclerotic-type cGVHD (n=9).
For the 5 vitiligo patients in whom the onset of skin depigmentation was documented, pigment changes occurred at a median of 41 months (range, 24-84) after transplant.
Depigmentation was classic periorbital, perioral, acrofacial involvement in 6 patients, generalized in 6 patients, and torso-predominant in 2 patients. Trichrome vitiligo was present in 3 patients, and poliosis occurred in 5 patients. In both AA patients, hair loss was localized to the scalp.
The researchers evaluated demographic, clinical, and laboratory data from these patients, and used univariate and multivariable logistic regression analyses to identify risk factors for vitiligo and AA.
Univariate analysis suggested the following factors were significantly associated with vitiligo and/or AA: female donor to male recipient sex mismatch (P=0.003), positive test results for ACA-IgG (P=0.03) or antiparietal antibody (P=0.049), elevated CD19 (P=0.045), and normal or elevated IgG (P=0.02).
However, only positive ACA-IgG results and female donor to male recipient mismatch retained significance in multivariable analysis (P=0.01 and P=0.003, respectively).
The researchers said additional studies are needed to clarify whether these risk factors can lead to a better understanding of the pathomechanisms of cGVHD.
Credit: PLOS ONE
Results of a retrospective study have revealed factors that appear to increase the risk of vitiligo and alopecia areata (AA) in patients who develop chronic graft-vs-host disease (cGVHD) after a stem cell transplant.
Multivariable analysis suggested that a female donor to male recipient sex mismatch and positive test results for anticardiolipin immunoglobulin G (ACA-IgG) were both significantly associated with vitiligo and/or AA.
This research was published in JAMA Dermatology.
Edward W. Cowen, MD, of the National Cancer Institute in Bethesda, Maryland, and his colleagues conducted the study in 282 adult and pediatric patients with cGVHD.
Fifteen of the patients (5.3%) had vitiligo and/or AA. One patient had only AA, 1 had vitiligo and AA, and the rest had vitiligo alone. The median age of these patients at enrollment was 38 years (range, 9-69 years), and most were male (n=10).
Most patients had received a transplant to treat chronic myelogenous leukemia (n=5) or acute leukemia/myelodysplastic syndrome (n=5). Most patients (n=13) had an HLA-identical donor and received a peripheral blood stem cell transplant (n=9).
Eleven patients had concomitant skin cGVHD at the time of evaluation, and it was most often sclerotic-type cGVHD (n=9).
For the 5 vitiligo patients in whom the onset of skin depigmentation was documented, pigment changes occurred at a median of 41 months (range, 24-84) after transplant.
Depigmentation was classic periorbital, perioral, acrofacial involvement in 6 patients, generalized in 6 patients, and torso-predominant in 2 patients. Trichrome vitiligo was present in 3 patients, and poliosis occurred in 5 patients. In both AA patients, hair loss was localized to the scalp.
The researchers evaluated demographic, clinical, and laboratory data from these patients, and used univariate and multivariable logistic regression analyses to identify risk factors for vitiligo and AA.
Univariate analysis suggested the following factors were significantly associated with vitiligo and/or AA: female donor to male recipient sex mismatch (P=0.003), positive test results for ACA-IgG (P=0.03) or antiparietal antibody (P=0.049), elevated CD19 (P=0.045), and normal or elevated IgG (P=0.02).
However, only positive ACA-IgG results and female donor to male recipient mismatch retained significance in multivariable analysis (P=0.01 and P=0.003, respectively).
The researchers said additional studies are needed to clarify whether these risk factors can lead to a better understanding of the pathomechanisms of cGVHD.