Document 0293
 DOCN  M9440293
 TI    Transfusion-associated graft-versus-host disease--report of two further
       cases with an immunohistochemical analysis.
 DT    9404
 AU    Arico M; Noto G; Pravata G; Bongiorno MR; Mirto S; Malizia G; Istituto
       di Dermatologia Sperimentale, University of Palermo,; Italy.
 SO    Clin Exp Dermatol. 1994 Jan;19(1):36-42. Unique Identifier : AIDSLINE
       MED/94147692
 AB    Transfusion-associated graft-vs.-host disease (tGVHD) is a severe
       disease usually affecting immunocompromised hosts with haematological
       neoplasia. Two patients with acute leukaemia are reported, who developed
       fatal tGVHD after blood transfusions. Intercellular adhesion molecule 1
       (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and endothelial
       leucocyte adhesion molecule 1 (ELAM-1) expression and the CD4/CD8 ratio
       were assessed in lesional skin. ICAM-1 was strongly expressed on
       epidermal keratinocytes and endothelial cells (EC) and correlated with
       HLA-DR staining. VCAM-1 was strongly expressed on EC in the superficial
       dermal vessels. ELAM-1 stained weakly on EC in some of the superficial
       vessels. CD8+ lymphocytes showed prominent epidermotropism; the CD4/CD8
       ratio was 0.8 in case 1 and 1.2 in case 2. Infiltrating cells were
       positive for CD3, CD11a, and CD18. Langerhans' cells were almost
       completely absent. The dermatologist must be aware of the importance of
       such a rare, unexpected and almost always fatal complication of blood
       transfusion, in order to make an early diagnosis. Irradiation of blood
       products is the only effective way to prevent tGVHD in all subjects at
       risk.
 DE    Blood Transfusion/*ADVERSE EFFECTS  Case Report  Cell Adhesion
       Molecules/ANALYSIS  CD4-CD8 Ratio  Fatal Outcome  Female  Graft vs Host
       Disease/*ETIOLOGY/IMMUNOLOGY/PATHOLOGY  Human  Leukemia, Nonlymphocytic,
       Acute/IMMUNOLOGY/*THERAPY  Leukemia, T-Cell, Acute/IMMUNOLOGY/*THERAPY
       Middle Age  Skin/*IMMUNOLOGY  JOURNAL ARTICLE

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