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Generalized vitiligo after lymphocyte infusion for relapsed leukaemia
1Department of Medicine, Queen Mary Hospital, University of Hong Kong. auwing@hotmail.com
The British Journal of Dermatology
|March 20, 2002
Summary
Vitiligo, an autoimmune condition, can iatrogenically develop after donor lymphocyte infusion (DLI) for leukemia relapse. This occurs due to T-lymphocytes from the donor destroying melanocytes, leading to skin depigmentation.
Area of Science:
- Immunology
- Dermatology
- Oncology
Background:
- Vitiligo is an autoimmune disorder characterized by melanocyte destruction.
- Bone marrow transplantation (BMT) and donor lymphocyte infusion (DLI) are used to treat hematologic malignancies.
Observation:
- Two patients developed generalized vitiligo after DLI for leukemia relapse, years post-BMT.
- Neither patient nor donor had prior vitiligo or autoimmune conditions.
- Graft-versus-host disease occurred post-DLI but was managed with immunosuppression.
Findings:
- Progressive, persistent skin depigmentation developed months after DLI.
- Molecular studies confirmed complete loss of host hematopoietic cells.
- Alloreactive donor T-lymphocytes likely mediated melanocyte destruction.
Implications:
- DLI can induce vitiligo as an iatrogenic autoimmune complication.
- Understanding DLI-induced vitiligo mechanisms is crucial for patient management.
- This highlights the potential for donor lymphocytes to target non-hematopoietic cells.