Dermatologic manifestations of graft-versus-host disease in patients undergoing bone marrow transplantation
DOI:
https://doi.org/10.33448/rsd-v11i8.30929Keywords:
Bone marrow transplantation; Graft vs host disease; Skin manifestations.Abstract
Complications of hematopoietic stem cell transplantation are due to the histocompatibility between recipient and donor, the most serious of which is graft-versus-host disease (GVHD), which can present in an acute form (aGVHD) or chronic form (cGVHD) with dermatological manifestations observed in both. The aim of this study was to describe the dermatological manifestations of GVHD in patients undergoing hematopoietic stem cell transplantation. This is a retrospective descriptive study, whose data source were the medical records of patients who underwent allogeneic hematopoietic stem cell transplantation between 2015 and 2020 in a High Complexity Oncology Care Center located in the city from Rio de Janeiro, Brazil. Simple statistical analyzes described the variables investigated. Of the 89 patients who developed GVHD, most developed aGVHD, 57 in the classic form and 14 in the late form. The mean time between transplantation and GVHD was 84.19 days, being 38.03 days for classic acute cases, 235.42 days for late acute cases and 146.08 days for chronic cases. In both aGVHD and cGVHD, the most frequent dermatological manifestations were erythema, macula, pruritus and desquamation, and the most frequent anatomical regions were the chest, face and upper limbs. The timely identification of the dermatological manifestations of GVHD in patients undergoing hematopoietic stem cell transplantation depends on a detailed anamnesis and a thorough physical examination.
References
Associação da Medula Óssea. (2020). Número de transplantes de medula óssea diminui cerca de 20% no Brasil durante o primeiro semestre de 2020. https://ameo.org.br/numero-de-transplantes-de-medula-ossea-diminui-cerca-de-20-no-brasil-durante-o-primeiro-semestre-de-2020/
Azevedo, W. Doença enxerto versus hospedeiro aguda A-GVHD. (2010). Revista Brasileira de Hematologia e Hemoterapia, 32(Supl. 1): 16-21. doi:10.1590/S1516-84842010005000060
Bouzas, L. F. S., Silva, M. M., Tavares, R. C. B. S., Moreira. M. C. R., Correa, M. E. P., Funke, V. A. M., Valdetaro. J., Souza, M. P., Colturato, V. A. R., Vigorito, A. C., Mauad, M. A., & Mauad, L. M. Q. (2010). Diretrizes para o diagnóstico, classificação, profilaxia e tratamento da doença enxerto contra hospedeiro crônica. Revista Brasileira de Hematologia e Hemoterapia, 32(Supl. 1): 22-39. 10.1590/S1516-84842010005000029
Cordeiro, I. R. R., Rodrigues, J. A. P., Piubello, S. M. N., & Niero, A. C. (2021). Nursing care for patients with graft-versus-host disease. Revista de Enferm UFPE On Line, 15(1), e245778. 10.5205/1981-8963.2021.245778
Flowers, M. E. D., Martin, P. J. (2015). How we treat chronic graft-versus-host disease. Blood, 125(4), 606-615. 10.1182/blood-2014-08-551994
Funke, V., Moreira, M. C. R, de Macedo, A. V., Melo, A., Schmidt Filho, J., Fatobene, G., Tavares, R. C. B. S., Silva, M. M., Macedo, M. C. M. A., Colella, M. P., Colturato, V., de Souza, M. P., Rodrigues, M., Feliciano, J. V. P., Bouzas, L. F. S., Vigorito, A., & Alves, M. (2021). Diagnosis and treatment of GVHD. Journal of Bone Marrow Transplantation and Cellular Therapy, 2(1), 164-173. doi:10.46765/2675-374X.2021v4n1p164-173
George, J.B. (2000). Teorias de enfermagem: os fundamentos para a prática profissional (4a ed.). Artmed.
Izu M., Silvino, Z. R., Santos, L. M., & Balbino, C. M. (2021). Nursing care for patients undergoing hematopoietic stem cell transplantation. Acta Paulista de Enfermagem, 34, eAPE02892. 10.37689/acta-ape/2021AR02892
Jagasia, M. H., Greinix, H. T., Arora, M., Williams, K. M., Wolff, D., Cowen, E. W., Palmer, J., Weisdorf, D., Treister, N. S., Cheng, G. S., Kerr, H., Stratton, P., Duarte, R. F., McDonald, G. B., Inamoto, Y., Vigorito, A., Arai, S., Datiles, M. B., Jacobsohn, D., Heller, T., Kitko, C. L., Mitchell, S. A., Martin, P. J., Shulman, H., Wu, R. S., Cutler, C. S., Vogelsang, G. B., Lee, S. J., Pavletic, S. Z., & Flowers. M. E. D. (2015). National institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. The 2014 diagnosis and staging working group report. Biology of Blood and Marrow Transplantation, 21(3), 389-401.e1. doi:10.1016/j.bbmt.2014.12.001
Kenyon, M., & Babic, A. (2018). The European blood and marrow transplantation textbook for nurses. London: Springer.
Malta, M., Cardoso, L. O., Bastos, F. I., Magnanini, M. M. F., & Silva, C. M. F. P. (2010). STROBE initiative: guidelines on reporting observational studies. Revista de Saúde Pública, 44(3), 559-565. doi:10.1590/S0034-89102010000300021
Marques, A. C. B., Szczepanik, A. P., Machado, C. A. M., Santos, P. N. D., Guimarães, P. R. B., & Kalinke, L. P. (2018). Hematopoietic stem cell transplantation and quality of life during the first year of treatment. Revista Latino-Americana de Enfermagem, 26, e3065. doi:10.1590/1518-8345.2474.3065
Murata, M. (2018). Acute graft-versus-host disease: diagnosis and treatment. Rinshō ketsueki, 59(5), 540-548. doi:10.11406/rinketsu.59.540
Nakamura, R., & Forman, S. J. (2014). Reduced intensity conditioning for allogeneic hematopoietic cell transplantation: considerations for evidence-based GVHD prophylaxis. Expert Review Hematology, 7(3), 407-421. doi:10.1586/17474086.2014.898561
Nightingale, F. (1989). Notas sobre enfermagem: o que é e o que não é. Cortez.
Nunes, S. S., Siqueira, H. C. H., da Silva, D. N., Sampaio, A. D., Medeiros, A. C., Rodrigues, S. T., & Thurow, M. R. B. (2020). Perfil sociodemográfico e clínico de transplantados de medula óssea: centros de referências no Brasil e Espanha. Research, Society and Development, 9(5), e19952931. 10.33448/rsd-v9i5.2931
Pasquini, R. & Coutinho, E. (2013). Fundamentos e Biologia do Transplante de Células-Tronco Hematopoiéticas. In Zago, M.A., Falcão, R., Covas, D.T. & Pasquini, R. (Orgs.), Tratado de Hematologia (1a ed., pp. 711-729). Atheneu.
Pinho, V. F. S. (2020). Clinical characteristics and complications of the haploidentical transplantation with post-transplant cyclophosphamide: implications for nursing. Revista Brasileira de Cancerologia, 66(1), e-01361. 10.32635/2176-9745.RBC.2020v66n1.361
Porto, C. C. (2012). Exame Clínico (7a ed.). Guanabara-Koogan.
Registro Brasileiro de Transplantes. (2020). Dimensionamento dos transplantes no Brasil e em cada estado (2013-2020). São Paulo: Associação Brasileira de Transplante de Órgãos.
Silva, M. M., Bouzas, L. F. S., & Filgueira, A. L. (2005). Manifestações tegumentares da doença enxerto contra hospedeiro em pacientes transplantados de medula óssea. Anais Brasileiros de Dermatologia, 80(1), 69-80. doi:10.1590/S0365-05962005000100010
Sociedade Brasileira de Transplante de Medula Óssea. (2020). Dados TCTH no Brasil (2008-2019). Rio de Janeiro: Sociedade Brasileira de Transplante de Medula Óssea.
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