Sjögren-type syndrome after allogeneic bone-marrow transplantation

Area of Science:

• Hematology
• Immunology
• Ophthalmology

Background:

• Bone marrow transplantation (BMT) is a crucial treatment for hematologic disorders.
• Graft-versus-host disease (GVHD) is a common complication following allogeneic BMT.
• Ocular and oral sicca symptoms can occur post-transplant but are not well-characterized.

Purpose of the Study:

• To investigate the occurrence and characteristics of Sjögren's syndrome-like symptoms in patients post-BMT.
• To correlate clinical and histological findings with graft-versus-host disease severity.

Main Methods:

• Evaluation of four allogeneic BMT recipients and two autologous BMT recipients for xerophthalmia and xerostomia.
• Clinical assessment, parotid gland function tests, minor salivary gland histopathology, and autoantibody screening.
• Correlation of findings with the severity of chronic graft-versus-host disease.

Main Results:

• Three allogeneic BMT recipients developed keratoconjunctivitis sicca; two showed decreased parotid gland function.
• All four allogeneic recipients exhibited minor salivary gland histopathology consistent with Sjögren's syndrome.
• Symptom and lesion severity correlated with chronic GVHD; other autoimmune manifestations were noted in some patients.

Conclusions:

• Allogeneic bone marrow transplantation can induce Sjögren's syndrome-like exocrinopathy.
• Chronic graft-versus-host disease is implicated in the pathogenesis of these post-transplant sicca symptoms.
• Autologous BMT recipients did not develop similar symptoms, highlighting the role of allogeneic factors.