Reflectance Confocal Microscopy Shows Promise for GVHD Diagnosis

In a study recently published in the journal Transplantation and Cellular Therapy, researchers investigated the use of reflectance confocal microscopy (RCM) imaging of legion sites in patients who had previously received allogeneic hematopoietic cell transplants (allo-HCT). The authors found that RCM can be used in the detection of cutaneous Graft Versus Host Disease (GVHD) features in post-allo-HCT patients.

Patients receiving allo-HCT are at risk of developing GVHD, which sees donor T cells attacking the transplant recipient. The researchers employed RCM imaging in 32 adult and pediatric post-allo-HCT patients who exhibited rashes. Two RCM devices were used - one for imaging lesions on flat surfaces of the body, and the other for imaging lesions on curved or harder to access areas.

Their findings demonstrated positive outcomes for RCM imaging as a diagnostic tool for GVHD, whereby effectively identifying histopathology features. The diagnoses of the 32 patients were as follows: early acute GvHD (aGVHD) (6.2%), late aGvHD (15.6%), nonsclerotic chronic GvHD (cGVHD) (56.4%), and sclerotic cGVHD (9.4%). Compared to skin biopsies, which do not always yield definitive diagnoses, can result in false-negative diagnoses, and carries scarring, bleeding, and infection risks, RCM imaging provides non-invasive, real time indicators of diseases to aid in diagnostic efforts.


Reingold RE, Monnier J, Ardigò M, et al. Real-time Reflectance Confocal Microscopy of Cutaneous Graft-versus-Host Disease Correlates with Histopathology [published online ahead of print, 2021 Sep 24]. Transplant Cell Ther. 2021;S2666-6367(21)01256-2.


Tags: GVHD, HCT, transplantation, Cellular therapy, diagnosis, promise, confocal, researchers, microscopy, RCM, imaging, all-HCT