CD8+lymphocytes in the blister fluid of severe acute cutaneous graft-versus-host disease: Further similarities with toxic epidermal necrolysis

Background: Graft-versus-host disease (GvHD) remains the major toxicity of allogeneic bone marrow transplantation (BMT). In the acute form of the dise ase, the differential diagnosis includes viral rash and drug eruptions. Met hods: We report two patients with chronic myeloid leukemia submitted to all ogeneic BMT who developed a severe form of acute cutaneous GvHD, with clini cal and histological pictures mimicking toxic epidermal necrolysis (TEN). R esults: We found a predominance of peripheral CD8+ T lymphocytes and, at th e same time, studying the cellular profile of the blister fluid, just in th e beginning of blister eruption, we also found a high proportion of CD8+ T lymphocytes, mainly CD8+CD57-.Conclusion: These data are in agreement with previous reports of the presence of CD8+ T cells in the blister fluid of pa tients with TEN, further emphasizing similar immunoinflammatory pathways in both diseases. Copyright (C) 2001 S. Karger AG, Basel.