Ocular graft-versus-host disease after hematopoietic cell transplantation: Expert review from the Late Effects and Quality of Life Working Committee of the CIBMTR and Transplant Complications Working Party of the EBMT.
Yoshihiro InamotoNuria Valdés-SanzYoko OgawaMonica AlvesLuigi BerchicciJohn GalvinHildegard GreinixGregory A HaleBiljana HornDebra KellyHien LiuScott RowleyHélène M SchoemansAmi ShahMaria Teresa Lupo StanghelliniVaibhav AgrawalIbrahim AhmedAsim AliNeel BhattMichael ByrneSaurabh ChhabraZack DeFilippKristina FahnehjelmNosha FarhadfarErich HornCatherine LeeSunita NathanOlaf PenackPinki PrasadSeth RotzAlicia RovóJean YaredSteven PavleticGrzegorz Władysław BasakMinoo BattiwallaRafael DuarteBipin N SavaniMary E D FlowersBronwen E ShawIgor PetričekPublished in: Bone marrow transplantation (2018)
Ocular graft-versus-host disease (GVHD) occurs in more than half of patients who develop chronic GVHD after allogeneic hematopoietic cell transplantation (HCT), causing prolonged morbidity, which affects activities of daily living and quality of life. Here we provide an expert review of ocular GVHD in a collaboration between transplant 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 in this review. Ocular GVHD has at least three biological processes: lacrimal gland dysfunction, meibomian gland dysfunction, and corneoconjunctival inflammation. Preclinical models have found several novel pathogenic mechanisms, including renin angiotensin system and endoplasmic reticulum stress signaling that can be targeted by therapeutic agents. Many studies have identified reliable tests for establishing diagnosis and response assessment of ocular GVHD. Efficacy of systemic and topical treatment for ocular GVHD is summarized. It is important for all health professionals taking care of HCT recipients to have adequate knowledge of ocular GVHD for optimal care.
Keyphrases
- allogeneic hematopoietic stem cell transplantation
- risk factors
- endoplasmic reticulum stress
- healthcare
- optic nerve
- palliative care
- primary care
- acute myeloid leukemia
- stem cells
- clinical practice
- low dose
- acute lymphoblastic leukemia
- cell therapy
- cell proliferation
- combination therapy
- mesenchymal stem cells
- smoking cessation
- replacement therapy