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Clinical Characteristics of Myositis Associated with Graft-Versus-Host Disease

  • Inflammatory Muscle Disease (L Diederichsen and H Chinoy, Section Editors)
  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Recipients of allogeneic hematopoietic stem cell transplantation (HSCT) are at increased risk for inflammatory myositis; histological subsets reported include dermatomyositis, necrotising myopathy and chronic graft-versus-host disease (cGVHD)–related myositis. Though corticosteroids and various immunosuppressive therapies have been used, there is a lack of consensus guidelines dictating therapy.

Recent Findings

Recent evidence suggests the fascia as a preferential target in cGVHD myositis, with conditioning regimens promoting fascial microtrauma. Positron emission tomography (PET) can be a useful diagnostic tool, and case reports suggest that the Bruton’s tyrosine kinase inhibitor ibrutinib may have therapeutic potential. Emerging therapies include targeted B cell depletion with rituximab, and extracorporeal photophoresis.

Summary

Clinicians need to be vigilant for the development of inflammatory myositis post-allogeneic HSCT as most patients respond to treatment. Advances in immunohistochemistry to determine the dominant cell type and cytokine profile may enable targeted and individualised therapies.

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Authors and Affiliations

  1. Department of Immunology, Concord Hospital, Hospital Road, Concord, NSW, 2139, Australia

    Sandhya Limaye

  2. Faculty of Medicine, University of Sydney, Sydney, Australia

    Sandhya Limaye

  3. Department of Rheumatology, Royal Adelaide Hospital, Port Road, Adelaide, SA, 5000, Australia

    Vidya Limaye

  4. Discipline of Medicine, University of Adelaide, Adelaide, Australia

    Vidya Limaye

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Limaye, S., Limaye, V. Clinical Characteristics of Myositis Associated with Graft-Versus-Host Disease. Curr Rheumatol Rep 23, 30 (2021). https://doi.org/10.1007/s11926-021-00996-x

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