Oral involvement of chronic graft-versus-host disease in hematopoietic stem cell transplant recipients.
Oral manifestations are common in patients who are diagnosed with chronic graft-versus-host-disease (cGVHD). These manifestations can present as oral mucosal lesions, salivary gland dysfunction, or reduction of the mouth opening due to cutaneous sclerosis. Although several studies have reported the prevalence of oral involvement in cGVHD, few have reported details of different types and severity of oral lesions of cGVHD, according to the NIH. Furthermore, the authors are aware of only one published study concerning oral manifestations of cGVHD in Brazil. The purpose of this study was to evaluate the prevalence and severity of oral involvement of cGVHD.  Oral evaluation of hematopoietic stem cell transplant (HSCT) recipients was conducted on 22 patients (12 men and 10 women) from December 2007 to May 2009. The following categories were assessed: Age, gender, underlying disease, time postHSCT, history of GVHD, therapy for GVHD, oral lesions, xerostomia, resting salivary flow rate, and mouth opening. Oral lesions were classified according to NIH criteria, and the results were submitted to a descriptive analysis. According to the NIH, patients presented diagnostic (40.9%), distinctive (31.9%), and common (9.1%) features of oral cGVHD. Oral involvement of cGVHD was identified in 81.8% of patients, 68.2% as mucosal lesions and 59.1% as salivary gland dysfunction. Reduced mouth opening was observed in 12 patients (80%), with one case associated with cutaneous sclerosis. Oral involvement was frequent in these patients; for many, it was the first clinical manifestation of cGVHD.
Universidade Federal do Rio de Janeiro, Brazil.
Cesar W
CW
Noce
Alessandra
A
Gomes
Alvaro
A
Copello
Raquel D
RD
Barbosa
Simone
S
Sant'anna
Maria Claudia R
MC
Moreira
Maria Elvira P
ME
Correa
Angelo
A
Maiolino
Sandra R
SR
Torres
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005882:Gingival Diseases / Q000453:epidemiology; D006086:Graft vs Host Disease / Q000453:epidemiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000706:statistics & numerical data*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000453:epidemiology; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology; D007972:Leukoplakia, Oral / Q000453:epidemiology; D017512:Lichenoid Eruptions / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000453:epidemiology*; D019226:Oral Ulcer / Q000453:epidemiology; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D012463:Saliva / Q000378:metabolism; D012636:Secretory Rate / Q000502:physiology; D014060:Tongue Diseases / Q000453:epidemiology; D014987:Xerostomia / Q000453:epidemiology; D055815:Young Adult
D007166:Immunosuppressive Agents