Abstract
Purpose :
The study aimed to determine whether chronic oGVHD can present as the sole organ manifestation after HSCT. We also compared the clinical presentation and treatment responses between oGVHD patients presenting with or without systemic organ manifestations. The study aimed to determine whether chronic oGVHD can present as the sole organ manifestation after HSCT. We also compared the clinical presentation and treatment responses between oGVHD patients presenting with or without systemic organ manifestations.
Methods :
This retrospective analysis was performed under a University of Illinois at Chicago (UIC) IRB-approved protocol in post-HSCT patients referred to the Dry Eye and oGVHD clinic at UIC. Definite oGVHD was diagnosed using the ICCGVHD classification based on the severity of ocular surface disease, signs and symptoms, and the presence/absence of systemic GVHD. The Wilcoxon Rank Sum Test (the Mann-Whitney U Test) with continuity correction was used to identify significant variations of continuous-data diagnostic scores. The Fisher's Exact Test with Yates continuity correction was used for categorical-data diagnostic scores.
Results :
Definite oGVHD was diagnosed in 200 patients. In 14% of patients (Group 1; n=28) with definite oGVHD, no other organs manifested systemic GVHD. In 86% of patients (Group 2; n=172) with definite oGVHD, other organ systems (skin, mouth, lung, liver, GI) also manifested systemic GVHD. There was no significant difference between the two groups in OSDI score (p=0.147) and VAS (p=0.117). However, compared to Group 2, Group 1 had significantly greater meibomian gland disease (p=0.007) and significantly greater corneal staining (p=0.0009). Group 1 also had significantly lower Schirmer’s I scores (p=0.029). Both definite oGVHD patients with and without systemic GVHD improved between their first and most recent visit; however, there is a significantly better treatment response for patients without systemic GVHD for corneal staining, and discomfort score with combinatorial treatment (steroid eye drop, serum tears, and pooled human immunoglobulin eye drops) as compared to topical steroid treatment alone.
Conclusions :
Chronic oGVHD may be the sole organ manifestation of chronic GVHD after HSCT and presents as a severe ocular surface disease, and responds well to combinatorial topical treatments.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.