Systemic Immunosuppressant Cessation/Tapering Linked to MGD Progression Post-HSCT.

Area of Science:

• Ophthalmology
• Hematology
• Immunology

Background:

• Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can lead to chronic ocular graft-versus-host disease (coGVHD).
• Meibomian gland dysfunction (MGD) is a common complication affecting the ocular surface after allo-HSCT.

Purpose of the Study:

• To examine longitudinal changes in meibomian gland structure and function post-allo-HSCT.
• To identify factors associated with these changes, particularly in relation to coGVHD.

Main Methods:

• Retrospective cohort study of 68 patients post-allo-HSCT (48 with coGVHD, 20 without).
• Analysis included demographic data, ocular surface assessments, and meibomian gland area ratio (MGAR) over a mean follow-up of 22.9 months.
• Generalized estimating equations were used to determine associated factors.

Main Results:

• While coGVHD severity improved, MGAR showed no significant change overall.
• MGAR remained stable in most eyes, but deteriorated in some.
• Cessation or tapering of systemic immunosuppressants was significantly associated with worsening MGAR in both coGVHD and non-coGVHD groups.

Conclusions:

• Improvement in coGVHD does not guarantee improvement in MGD after allo-HSCT.
• Systemic immunosuppressant reduction is a risk factor for MGD progression post-transplant.