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Chronic graft-versus-host disease (c GVHD) is a common complication following allogeneic stem-cell transplantation ( SCT). Past studies have implicated the persistence of host antigen-presenting cells ( APCs) in GVHD. Our objective was to determine the frequency of host Langerhans cells ( LCs) in normal skin post- SCT and ask if their persistence could predict c GVHD. Biopsies of normal skin from 124 sex-mismatched T-cell-replete allogenic SCT recipients were taken 100 days post-transplant. Patients with acute GVHD and those with <9 months of follow-up were excluded and prospective follow-up information was collected from remaining 22 patients. CD1a staining and X and Y chromosome in-situ hybridization were performed to label LCs and to identify their host or donor origin. At 3 months, 59 ± 5% of LCs were host derived. The density of LCs and the proportion of host-derived LCs were similar between patients that did or did not develop c GVHD. Most LCs in the skin remained of host origin 3 months after SCT regardless of c GVHD status. This finding is in line with the redundant role of LCs in acute GVHD initiation uncovered in recent experimental models. [ABSTRACT FROM AUTHOR]