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Sirolimus as Long-term Graft-versus-host-disease Prophylaxis in Haploidentical Hematopoietic Stem Cell Transplant Recipients for Non-malignant Disorders is Associated with High Incidence of Acneiform Lesions
BACKGROUND: Sirolimus has provided the option for calcineurin inhibitor (CNI)-free immunosuppressive therapy in both solid organ transplant (SOT) and hematopoietic stem cell transplantation (HSCT). However, long-term use of sirolimus has been reported to be associated with a high incidence of cutane...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681198/ https://www.ncbi.nlm.nih.gov/pubmed/26677273 http://dx.doi.org/10.4103/0019-5154.169131 |
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author | Chakrbarti, Aditi Jaiswal, Sarita Rani Chakrabarti, Suparno |
author_facet | Chakrbarti, Aditi Jaiswal, Sarita Rani Chakrabarti, Suparno |
author_sort | Chakrbarti, Aditi |
collection | PubMed |
description | BACKGROUND: Sirolimus has provided the option for calcineurin inhibitor (CNI)-free immunosuppressive therapy in both solid organ transplant (SOT) and hematopoietic stem cell transplantation (HSCT). However, long-term use of sirolimus has been reported to be associated with a high incidence of cutaneous side effects in SOT, particularly acneiform lesions. MATERIALS AND METHODS: We studied the incidence of acneiform lesions and the risk factors in 41 HSCT recipients between ages 4 and 64 years, undergoing HSCT for malignant (n = 29) and non-malignant diseases (n = 12) from haploidentical family donors. RESULTS: Seven patients developed acneiform lesions at the median of 85 days (range, 45–105 days). Acneiform lesions occurred in 6/11 patients on sirolimus and in only 1/30 patients not receiving sirolimus (P = 0.001). This was more frequent in patients with non-malignant disorders (5/12 versus 2/29, P = 0.01) and those receiving graft from female donors (7/23 versus 0/18, P = 0.01). CONCLUSIONS: Despite being frequently reported in SOT, this is the first such report in HSCT. Our study suggests that prolonged use of sirolimus might be associated with high incidence of acneiform lesions in haploidentical HSCT recipients with non-malignant diseases, particularly in those receiving graft from a female donor. We discuss the possible reasons for these findings and the putative mechanism of acneiform lesions in these patients |
format | Online Article Text |
id | pubmed-4681198 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-46811982015-12-16 Sirolimus as Long-term Graft-versus-host-disease Prophylaxis in Haploidentical Hematopoietic Stem Cell Transplant Recipients for Non-malignant Disorders is Associated with High Incidence of Acneiform Lesions Chakrbarti, Aditi Jaiswal, Sarita Rani Chakrabarti, Suparno Indian J Dermatol Short Communication BACKGROUND: Sirolimus has provided the option for calcineurin inhibitor (CNI)-free immunosuppressive therapy in both solid organ transplant (SOT) and hematopoietic stem cell transplantation (HSCT). However, long-term use of sirolimus has been reported to be associated with a high incidence of cutaneous side effects in SOT, particularly acneiform lesions. MATERIALS AND METHODS: We studied the incidence of acneiform lesions and the risk factors in 41 HSCT recipients between ages 4 and 64 years, undergoing HSCT for malignant (n = 29) and non-malignant diseases (n = 12) from haploidentical family donors. RESULTS: Seven patients developed acneiform lesions at the median of 85 days (range, 45–105 days). Acneiform lesions occurred in 6/11 patients on sirolimus and in only 1/30 patients not receiving sirolimus (P = 0.001). This was more frequent in patients with non-malignant disorders (5/12 versus 2/29, P = 0.01) and those receiving graft from female donors (7/23 versus 0/18, P = 0.01). CONCLUSIONS: Despite being frequently reported in SOT, this is the first such report in HSCT. Our study suggests that prolonged use of sirolimus might be associated with high incidence of acneiform lesions in haploidentical HSCT recipients with non-malignant diseases, particularly in those receiving graft from a female donor. We discuss the possible reasons for these findings and the putative mechanism of acneiform lesions in these patients Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4681198/ /pubmed/26677273 http://dx.doi.org/10.4103/0019-5154.169131 Text en Copyright: © 2015 Indian Journal of Dermatology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Short Communication Chakrbarti, Aditi Jaiswal, Sarita Rani Chakrabarti, Suparno Sirolimus as Long-term Graft-versus-host-disease Prophylaxis in Haploidentical Hematopoietic Stem Cell Transplant Recipients for Non-malignant Disorders is Associated with High Incidence of Acneiform Lesions |
title | Sirolimus as Long-term Graft-versus-host-disease Prophylaxis in Haploidentical Hematopoietic Stem Cell Transplant Recipients for Non-malignant Disorders is Associated with High Incidence of Acneiform Lesions |
title_full | Sirolimus as Long-term Graft-versus-host-disease Prophylaxis in Haploidentical Hematopoietic Stem Cell Transplant Recipients for Non-malignant Disorders is Associated with High Incidence of Acneiform Lesions |
title_fullStr | Sirolimus as Long-term Graft-versus-host-disease Prophylaxis in Haploidentical Hematopoietic Stem Cell Transplant Recipients for Non-malignant Disorders is Associated with High Incidence of Acneiform Lesions |
title_full_unstemmed | Sirolimus as Long-term Graft-versus-host-disease Prophylaxis in Haploidentical Hematopoietic Stem Cell Transplant Recipients for Non-malignant Disorders is Associated with High Incidence of Acneiform Lesions |
title_short | Sirolimus as Long-term Graft-versus-host-disease Prophylaxis in Haploidentical Hematopoietic Stem Cell Transplant Recipients for Non-malignant Disorders is Associated with High Incidence of Acneiform Lesions |
title_sort | sirolimus as long-term graft-versus-host-disease prophylaxis in haploidentical hematopoietic stem cell transplant recipients for non-malignant disorders is associated with high incidence of acneiform lesions |
topic | Short Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681198/ https://www.ncbi.nlm.nih.gov/pubmed/26677273 http://dx.doi.org/10.4103/0019-5154.169131 |
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