Naevi in allogeneic bone marrow transplantation recipients: the effect of XXXX on naevi.

@entity1 @entity32 @entity82 @entity1489 @entity2132 @entity272 @entity320
BACKGROUND: Non- @entity320 @entity1489 is more common in transplant recipients, probably because of immunosuppression. An increased risk of developing @entity320 could be a late effect of transplantation. The number of naevi, which is a risk marker for @entity320 , is increased in renal transplant recipients of all ages and may be related to immunosuppression. The risk of @entity320 has been suspected to be particularly high after bone marrow transplantation. @entity2132 ( @entity2132 ) might be an interesting model for the study of interactions between naevi and the immune system. OBJECTIVE: To assess whether aBMT exposes an individual to a particularly high risk of @entity320 , using naevi as a surrogate measure of the risk. To improve our knowledge of the effect of the immune system on naevi, using @entity2132 as a model. METHODS: We carried out an epidemiological case-control study with two age-, sex- and hair colour-matched controls for each case. The results were analysed with analysis of variance, a general linear model analysis and multivariate analysis. RESULTS: The number of naevi was not significantly increased in aBMT @entity1 , as compared with controls, although there was a significant excess on the palms and legs. In exploratory subgroup case-control comparisons and with the general linear model, @entity1 who were conditioned with a combination of two alkylating drugs at high doses, and @entity1 who had an aBMT before the age of 20 years tended to have a higher count of naevi (P = 0.002 and P = 0.06, respectively). Conversely, there was a trend in favour of a lower count of naevi in @entity1 with @entity272 of chronic @entity2132 (P = 0.01). These data were corroborated by multivariate analysis, which showed that conditioning with high-dose chemotherapy, the absence of severe chronic cutaneous @entity2132 and a young age at transplantation were the main variables that independently predicted an excess of naevi. CONCLUSIONS: This study of aBMT @entity1 confirms that chemotherapy stimulates naevus growth. It also suggests for the first time that diffuse lesions of chronic cutaneous @entity2132 are associated with a decreased number of naevi. Whether allo-immunity, chronic @entity32 or the masking of naevi by pigmentation and @entity82 is responsible for the decreased number of naevi requires further investigation. With respect to the long-term risk of @entity320 in aBMT recipients, our results support an increased risk particularly when aBMT is performed at a young age, and when conditioning is with high doses of alkylating drugs.
