LICHENOID GRAFT-VS-HOST DISEASE IN AN AUTOLOGOUS BONE-MARROW TRANSPLANT RECIPIENT

Background: Graft-vs-host disease (GVHD) represents one of the major c omplications of allogeneic bone marrow transplantation (BMT) but is le ss common in autologous BMT. Following autologous BMT, chronic GVHD ha s been reported in only four patients, all of whom had a self-limited sclerodermoid form. Lichenoid chronic GVHD has not been previously rep orted in an autologous BMT patient. Observations: Mucosal and cutaneou s lichenoid lesions and histologic findings compatible with chronic li chenoid GVHD developed in a patient 35 days after autologous BMT was p erformed. The onset of clinical lesions at 35 days after BMT is not in congruent with the diagnosis of chronic lichenoid GVHD (rather than a graft vs-host reaction) and may have been augmented by cyclosporin A i n a manner similar to animal model experiments. Conclusion: All forms of GVHD can and do occur following autologous BMT.