Permanent Diffuse Alopecia After Hematopoietic Stem Cell Transplantation in Childhood

    March 2017 in “ Bone Marrow Transplantation ”
    Dorine Bresters, Dominique C.M. Wanders, Marloes Louwerens, Lynne M. Ball, M. Fiocco, Remco van Doorn
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    TLDR Some children who had stem cell transplants developed permanent hair loss, especially when treated with a drug called busulphan.
    The study assessed the prevalence and risk factors of permanent alopecia in 263 patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) before age 19, from January 1990 to January 2013. It found that 15.6% (41/263) of the patients developed permanent alopecia, primarily diffuse in nature. The use of busulphan, with or without fludarabine, in the conditioning regimen was significantly associated with alopecia, while total body irradiation (TBI) and other alkylating agents were not. Both acute and chronic graft-versus-host disease (GvHD) were also linked to alopecia. The study suggests that replacing busulphan with treosulfan could reduce alopecia risk and emphasizes the need for further research on prevention and treatment due to the psychological impact on patients. Limitations included the lack of a strict alopecia definition and possible misclassification due to reliance on clinical assessment.
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