Heal House Vitiligo Research 04 · Original Article
Can vitiligo develop after hematopoietic stem cell transplant (bone marrow transplant)?
Subsequent vitiligo after hematopoietic stem cell transplantation: A nationwide population-based cohort study from Korea.
Last reviewed
In short
People who received a hematopoietic stem cell transplant were about three times more likely to develop new-onset vitiligo than those who did not. The risk was especially higher with allogeneic transplants and when cells from bone marrow were used.
We often saw patients who developed vitiligo after receiving a hematopoietic stem cell transplant for leukemia. A hematopoietic stem cell transplant replaces your bone marrow, including immune cells, with someone else's. So a new immune response appears in the body. The foreign immune cells can attack all of your cells. Of course, a process to make the new immune system recognize your body is also carried out. We started this study to find that connection.
Q1 Does stem cell transplant really increase the risk of developing vitiligo?
Yes, it was more common. We followed 2,747 people who received a transplant and 8,241 who did not. Among those who received a transplant, 1.06% — about 1 in 100 — developed new vitiligo. Among those who did not receive a transplant, it was 0.34%, about one-third of that. As a ratio, that is about 3 times higher. Although it is a rare event, the difference was unlikely to be due to chance.
Vitiligo occurrence by transplant status
| Item | Value | In simple terms |
|---|---|---|
| Transplant recipients | 1.06% | About 1 in 100 |
| Non-transplant group | 0.34% | About one-third the level |
| Odds ratio (OR) | 3.13 | About 3 times higher |
Q2 In which cases was the risk higher?
There were two cases. When cells from another person were transplanted, the risk was about 5.6 times higher. When cells obtained from bone marrow were used instead of peripheral blood, the risk was about 2.5 times higher. This shows that in the process of the new immune cells adapting to your body, they may mistake pigment cells for "foreign" and attack them. Vitiligo that develops after a transplant is likely not mere chance but the result of an immune response.
Q3 What do these findings mean?
Patients who are about to undergo or have already received a transplant, as well as the dermatologists in charge of the transplant, can now keep the possibility of vitiligo in mind in advance. If you notice new white patches, do not be alarmed; it may be a reaction related to the transplant, so you can seek medical attention early. At the same time, this result aligns well with the broader picture that vitiligo occurs when immune cells attack pigment cells. The special situation of a transplant, in a way, reflects the mechanism of vitiligo in reverse.
Closing remarks
This is the first time vitiligo occurring after transplant has been confirmed using nationwide data. We also identified which transplant methods are more likely to lead to it. Thanks to this, when we see transplant recipients, we now pay closer attention to skin changes. We can also explain the reason with evidence to those who develop new spots. Even if it is rare, understanding the principle reduces fear.
