Bilateral corneal ulceration in ocular graft-versus-host disease

Figures & data

Table 1 Patient characteristics

	Case 1	Case 2	Case 3	Case 4
Age/sex	53/male	28/female	59/female	39/male
Underlying disease	ALL	AML	CML	NHL
Conditioning regimen	Myeloablative Cytoxan/TBI	Myeloablative Cytoxan/TBI	Myeloablative Cytoxan/TBI	Nonmyeloablative fludarabine/busulfan
Donor sex/relation	Male/unrelated	Male/unrelated	Male/related	Female/related
Donor HLA status	Matched 6/6	Matched 5/6	Matched 5/6	Matched 6/6
Date of HSCT	12/18/2008	4/4/2008	8/22/1997	2/15/2006
Transplant type	PBSCT	PBSCT	BMT	PBSCT
GVHD prophylaxis	Tacrolimus, sirolimus	Prednisolone, tacrolimus, sirolimus	Cyclosporine	Cyclosporine
GVHD manifestations	Skin, liver, eyes	Liver, lungs, eyes	Eyes	Skin, liver, eyes
Days from HSCT to ocular	447	445	4,897	115
GVHD diagnosis
Days from HSCT to ulceration	OD: 1,287	OD: 670	OD: 5,065	OD: 1,910
	OS: 881	OS: 1,315	OS: 5,155	OS: 1,919
Days from HSCT to perforation	OS: 901	OD: 670	NA	NA
Culture results	Staphylococcus aureus	Hemolytic streptococci	NA	NA
Visual acuity at presentation	OD: 20/100	OD: 20/200	OD: 20/40	OD: 20/400
	OS: CF @ 1 foot	OS: 20/300	OS: 20/100	OS: 20/200
Visual acuity at last follow-up visit	OD: 20/30	OD: 20/30	OD: 20/30	OD: hand motion
	OS: 20/400	OS: 20/30	OS: 20/30	OS: 20/80
Duration of topical corticosteroids before ulceration	Unknown	OD: 2 weeks	OD: NA	NA
		OS: 3 weeks	OS: 1 week
Duration of oral corticosteroids before ulceration	2 months	15 months	NA	60 months

Abbreviations: ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; NHL, non-Hodgkin’s lymphoma; CML, chronic myeloid leukemia; TBI, total body irradiation; HLA, human leukocyte antigen; HSCT, hematopoietic stem cell transplantation; PBSCT, peripheral blood stem cell transplantation; BMT, bone marrow transplantation; GVHD, graft-versus-host disease; OD, right eye; OS, left eye; CF, count fingers; NA, not applicable.