Subsequent vitiligo after hematopoietic stem cell transplantation: A nationwide population-based cohort study from Korea

Background Subsequent vitiligo after hematopoietic stem cell transplantation (HSCT) has been described sporadically in case series. Objective To investigate the incidence and risk factors of subsequent vitiligo after HSCT. Methods A nationwide, population-based cohort study was performed using the Korean National Health Insurance Claims Database from 2009 to 2013. All HSCT recipients who had undergone HSCT between 2010 and 2011 and not treatment for vitiligo in 2009 (to exclude preexisting active vitiligo) were included in the HSCT recipient group, and an age- and sex-matched control group without HSCT was also established. Results A total of 2747 HSCT recipients and 8241 controls were enrolled. Newly acquired vitiligo occurred in 1.06% of HSCT recipients between 2010 and 2013, and there was a significant increase (OR 3.130, 95% CI 1.859-5.271) in cases of vitiligo in HSCT recipients compared with controls (0.34%). Allogeneic HSCT (OR 5.593, 95% CI 1.628-19.213) and bone marrow-sourced stem cells (as compared with peripheral blood-sourced stem cells; OR 2.492, 95% CI 1.114-5.576) were independently associated with the development of vitiligo after HSCT. Limitations Medical record review was not available. Conclusion Vitiligo developed at a significantly increased rate after HSCT compared with controls. Allogeneic HSCT and bone marrow–sourced stem cells were independent risk factors.