How we treat oral chronic graft-versus-host disease.
Chronic graft-versus-host disease (cGVHD) is a major complication of allogeneic hematopoietic cell transplantation that is associated with a diminished quality of life. The oral cavity is frequently affected, with a wide variety of signs and symptoms that can result in significant short- and long-term complications ranging from mucosal sensitivity and limited oral intake to secondary malignancy and early death. This article provides a comprehensive approach to the diagnosis and clinical management of patients with oral cGVHD, with particular attention to differential diagnosis, control of symptoms, and prevention of and screening for secondary complications. The clinical considerations and recommendations presented are intended to be practical and relevant for all clinicians involved in the care of patients with oral cGVHD, with the ultimate goal of improving care and outcomes.
Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA. ntreister@partners.org
Nathaniel
N
Treister
Christine
C
Duncan
Corey
C
Cutler
Leslie
L
Lehmann
D000305:Adrenal Cortex Hormones / Q000494:pharmacology / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002180:Candidiasis, Oral / Q000188:drug therapy / Q000276:immunology; D002908:Chronic Disease; D003731:Dental Caries / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D004334:Drug Administration Schedule; D006086:Graft vs Host Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D009055:Mouth / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D009061:Mouth Mucosa / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D012469:Salivary Glands / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D014184:Transplantation, Homologous
D000305:Adrenal Cortex Hormones; D000935:Antifungal Agents; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents