Recognition, incidence, and management of oral graft-versus-host disease.
Acute and chronic graft-versus-host disease (GVHD) are significant complications of allogeneic bone marrow transplantation that occur when immunologically active T-cell lymphocytes are transplanted into an immunosuppressed recipient who is genetically disparate from the marrow donor. Oral GVHD lesions closely resemble those seen with a number of autoimmune connective tissue disease, including lichen planus, systemic sclerosis, lupus erythematosus, and Sjögren's syndrome. Mucosal erythema, atrophy, and ulceration are noted clinically; lichen planus-like lesions are the most distinctive oral lesions. Salivary gland changes include changes in both flow rate and sialochemistry. Oral involvement ranges between 33% and 75% for patients with acute GVHD and upwards of 80% for those with chronic GVHD. Management of oral GVHD lesions depends on successful systemic therapy, although topical steroids can be of help in some instances.
Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
M M
MM
Schubert
K M
KM
Sullivan
D000208:Acute Disease; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000209:etiology* / Q000628:therapy; D006801:Humans; D009059:Mouth Diseases / Q000209:etiology* / Q000628:therapy