移植レシピエントでは白斑リスクが上昇
同種異系移植または自家移植、移植片対宿主病の有無によらずリスク上昇
韓国カトリック大学（韓国）のChul Hwan Bang氏らは、2010年1月～2017年12月に移植〔固形臓器移植（SOT）またはHSCT）を受けた20歳以上の患者について、韓国の国民健康保険サービスのデータを含む、地域住民を対象としたコホート研究を実施した。患者は、年齢および性別で1対5の割合でマッチさせた、移植を受けていない対照群と比較された。解析の対象には、SOTまたはHSCTを受けた患者2万3,829人と、対照群11万9,145人のデータが含まれた。
解析の結果、移植を受けた患者の白斑リスクは、対照群より有意に高かった（調整ハザード比1.73）。対照群と比べた白斑リスクは、腎移植および肝移植レシピエントにおいて、わずかに高かったが、HSCTレシピエントで最も高かった（同12.69）。同種異系移植を受けた人、自家移植を受けた人、移植片対宿主病（GVHD）を併発している人、非GVHDの人は、対照群と比べて白斑のリスクが高かった。
著者らは、「この知見は、移植レシピエントにおける白斑発症率を推定し、集学的アプローチによるモニタリングを実施することにより、白斑病変の早期発見と管理が改善されることを示唆している」と述べている。
Abstract/Full Text (subscription or payment may be required)
Risk for Vitiligo Increased for Transplant Recipients
Increased risk seen for those receiving allogeneic grafts and autologous grafts, as well as those with and without comorbid GVHD
THURSDAY, Dec. 21, 2023 (HealthDay News) -- Transplant recipients, especially those receiving hematopoietic stem cell transplant (HSCT), have an increased risk for vitiligo, according to a brief report published online Dec. 13 in JAMA Dermatology.
Chul Hwan Bang, M.D., Ph.D., from the Catholic University of Korea in Seoul, and colleagues conducted a population-based cohort study including data from the National Health Insurance Service database of Korea for patients aged 20 years or older who had received a transplant (solid organ transplant [SOT] or HSCT) between January 2010 and December 2017. Patients were compared to age- and sex-matched (1:5) controls who did not receive a transplant. Data were included for 23,829 patients who underwent SOT or HSCT and 119,145 controls.
The researchers found that the risk for vitiligo was significantly higher for patients who had undergone transplant than controls (adjusted hazard ratio, 1.73). Kidney and liver transplant recipients also had a slightly higher risk for vitiligo compared with controls, but risk was highest in HSCT recipients (adjusted hazard ratio, 12.69). Compared with controls, those who received allogeneic grafts, those who received autologous grafts, those with comorbid graft-versus-host disease (GVHD), and those without GVHD had a higher risk for vitiligo.
"The findings suggest that early detection and management of vitiligo lesions can be improved by estimating the likelihood of its development in transplant recipients and implementing a multidisciplinary approach for monitoring," the authors write.
Abstract/Full Text (subscription or payment may be required)