FACTORS AFFECTING HAIR REGROWTH AFTER BONE-MARROW TRANSPLANTATION

Permanent alopecia after BMT has been reported as a side-effect associ ated with GVHD or after busulphan conditioning therapy, primarily in a dults. We have reviewed children undergoing BMT to document the freque ncy of incomplete hair regrowth and to evaluate factors associated wit h this problem. Hair regrowth was studied in 74 children who survived > 6 months following BMT undertaken for malignant and nonmalignant dis eases. Alopecia was categorised as severe (< 50% of pre-transplant sta tus), moderate (50-75%) or mild (> 75% but less than normal). Overall, 18 (24.3%) of 74 patients had mild (n = 5), moderate (n = 4) or sever e (n = 9) alopecia. Risk factors for alopecia were presence of chronic GVHD (67%, p < 0.001), older age (p < 0.001) and prior cranial irradi ation (42%; p = 0.03). Alopecia occurred in children receiving either busulphan (31%) or total body irradiation (16%; p = 0.15) as condition ing therapy. The highest frequency was seen in patients conditioned wi th busulphan with or without melphalan and who received prior cranial irradiation and/or developed chronic GVHD (75%). These data indicate t hat alopecia after BMT in children is a significant problem and confir m, in children, the previously noted association between alopecia and chronic GVHD and busulphan. Further risk factors of older age and prio r cranial irradiation are identified. Consideration needs to be given to the use of an alternative to busulphan in children who are of older age, have received prior cranial irradiation and/or are at increased risk of GVHD.