Graft versus host disease: a pediatric perspective

Simon S.M. Fung, Uri Elbaz, Kamiar Mireskandari, Asim Ali*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Allogeneic hematopoietic stem cell transplantation (HSCT) is an established treatment of myeloid and lymphoid malignancies, solid tumors and a number of metabolic conditions in children. An important treatment complication is graft-versus-host disease (GVHD)–a multiorgan condition with significant morbidity and mortality post-HSCT including ocular complications. Areas covered: In this article, we reviewed the literature on pediatric ocular GVHD, including its incidence and risk factors, clinical features, current diagnostic criteria and clinical grading, treatment strategies and disease prognosis. Expert opinion: Even though less frequent than in adults, ocular GVHD remains a common complication in children after HSCT. Clinical features of pediatric ocular GVHD include keratoconjunctivitis sicca, pseudomembranous and cicatricial conjunctivitis, keratopathy, lid deformities, and meibomian gland dysfunction. Diagnosing and monitoring ocular GVHD in children are challenging as current criteria are poorly adapted for the pediatric cohort. Treatment strategies of pediatric ocular GVHD focus on controlling inflammation and optimizing the tear film to protect and maintain the ocular surface.

Original languageEnglish
Pages (from-to)89-99
Number of pages11
JournalExpert Review of Ophthalmology
Volume14
Issue number2
DOIs
StatePublished - 4 Mar 2019

Keywords

  • BMT
  • Graft-versus-host disease
  • HSCT
  • bone marrow transplantation
  • children
  • dry eye
  • hematopoietic stem cell transplantation
  • keratoconjunctivitis sicca
  • pediatric

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