Ocular Graft-versus-Host Disease after Hematopoietic Cell Transplantation: Expert Review from the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation |
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| Authors: | Yoshihiro Inamoto Nuria Valdés-Sanz Yoko Ogawa Monica Alves Luigi Berchicci John Galvin Hildegard Greinix Gregory A. Hale Biljana Horn Debra Kelly Hien Liu Scott Rowley Helene Schoemans Ami Shah Maria Teresa Lupo Stanghellini Vaibhav Agrawal Ibrahim Ahmed Asim Ali Igor Petriček |
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| Affiliation: | 1. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan;2. Department of Ophthalmology, Puerta de Hierro University Hospital, Madrid, Spain;3. Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan;4. Department of Ophthalmology, University of Campinas, Campinas, Brazil;5. Ophthalmology Department, San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy;6. Department of Medicine, University of Illinois at Chicago, Chicago, Illinois;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, Florida;9. UFHealth Shands Cancer Hospital, University of Florida, Gainesville, Florida;10. H. Lee Moffitt Cancer Center, Cleveland, Ohio;11. Hackensack University Medical Center, Washington, DC;12. Department of Hematology, University Hospital Leuven, Leuven, Belgium;13. Division of Stem Cell Transplantation and Regenerative Medicine, Lucille Packard Children''s Hospital, Stanford School of Medicine, Palo Alto, California;14. Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy;15. Simon Cancer Center, Indiana University, Indianapolis, Indiana;16. Department of Hematology Oncology and Bone Marrow Transplantation, The Children''s Mercy Hospitals and Clinics, Kansas City, Missouri;17. Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada;18. Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin;19. Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee;20. Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, Massachusetts;21. Department of Clinical Neuroscience, Karolinska Institute, St Erik Eye Hospital, Stockholm, Sweden;22. Utah Blood and Marrow Transplant Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah;23. Rush University Medical Center, Chicago, Illinois;24. Division of Hematology and Oncology, Department of Internal Medicine, Charité University Medicine, Campus Rudolf Virchow, Berlin, Germany;25. Lousiana State University Children''s Hospital, New Orleans, Louisiana;26. Cincinnati Children''s Hospital Medical Center, Cincinnati, Ohio;27. Bern University Hospital, Bern, Switzerland;28. Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland;29. Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland;30. Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland;31. Hematology Branch, Sarah Cannon BMT Program, Nashville, Tennessee;32. Hematopoietic Transplantation and Hemato-oncology Section, Puerta de HierroUniversity Hospital, Madrid, Spain;33. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington;34. Department of Ophthalmology, University Clinical Hospital Zagreb, Zagreb, Croatia |
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| Abstract: | Ocular graft-versus-host disease (GVHD) occurs in more than one-half of patients who develop chronic GVHD after allogeneic hematopoietic cell transplantation (HCT), causing prolonged morbidity that affects activities of daily living and quality of life. Here we provide an expert review of ocular GVHD in a collaboration between transplantation 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. Ocular GVHD involves at least 3 biological processes: lacrimal gland dysfunction, meibomian gland dysfunction, and corneoconjunctival inflammation. Preclinical models have identified several novel pathogenic mechanisms, including the renin angiotensin system and endoplasmic reticulum stress signaling, which can be targeted by therapeutic agents. Numerous studies have identified reliable tests for establishing diagnosis and response assessment of ocular GVHD. The efficacy of systemic and topical treatment for ocular GVHD is summarized. It is important that all health professionals caring for HCT recipients have adequate knowledge of ocular GVHD to provide optimal care. |
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| Keywords: | Chronic graft-versus-host disease Eye Review Biology Treatment Hematopoietic cell transplantation |
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