How do I treat oral chronic graft-versus-host disease?

BJH - volume 13, issue 8, december 2022

A.M. Laheij, DDS, PhD, J.E. Raber-Durlacher, DDS, PhD, M.D. Hazenberg MD, PhD, M.C. Schoordijk , M.C. Huysmans, DDS, PhD, J.G. de Visscher, DDS, MD, PhD


Allogeneic stem cell transplantation recipients may develop chronic graft-versus-host disease (cGVHD). The oral and perioral tissues are commonly involved, clinically manifesting as mucosal lesions, salivary gland dysfunction and/or sclerotic changes. Oral cGVHD is associated with mucosal sensitivity and pain, (severe) oral dryness, altered taste, decreased mouth opening, all of which may contribute to a significant decrease of the patient’s quality of life. Hyposalivation may put patients at risk for mucosal infections and rampant dental caries. In addition, patients with (a history) of oral cGVHD are at increased risk for oral squamous cell carcinoma. The diagnosis of cGVHD is based on the patient’s medical history, clinical signs, and symptoms. In rare cases, a biopsy may provide clinically relevant information as the histopathology findings are mostly not very specific. Treatment of cGVHD is based on the patient’s symptoms and consists preferably of local immunosuppressants. In case of severe oral complaints and when other non-oral body are also involved systemic immunosuppressive therapy should be considered. Xerostomia can be alleviated with mechanical stimulation, topical dry mouth relief products or sialagogues. Dental professionals can provide supportive care aimed at reducing symptoms and prevention of further deterioration of oral health.

(BELG J HEMATOL 2022;13(8):302–9)

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