Assessing the relationship between oral chronic graft-versus-host disease and global measures of quality of life.
OBJECTIVE
Chronic GVHD (cGVHD) is a frequent complication of allogeneic hematopoietic stem cell transplantation (HSCT) and affects multiple organ systems, with the oral cavity being one of the most frequently affected sites. Patients with cGVHD experience reduced quality of life (QOL), yet the specific impact of oral cGVHD on QOL is poorly understood. The objective of this study was to characterize the impact of oral cGVHD on global measures of QOL.


METHODS
QOL data were collected using the FACT-BMT and SF-36 instruments for 569 patients enrolled in the Chronic GVHD Consortium, with a total of 1915 follow-up visits. At study enrollment, patients were categorized as isolated oral cGVHD (n=22), oral and concomitant extra-oral cGVHD (n=420), and only extra-oral cGVHD (n=127). Utilizing all longitudinal data, QOL scores were compared using a multivariable linear model controlling for demographic, transplant, and cGVHD characteristics.


RESULTS
Patients with isolated oral cGVHD reported better physical well-being (P=0.009), BMT well-being (P=0.01), and decreased bodily pain (P=0.01) compared to patients with oral and concomitant extra-oral cGVHD, but the differences in scores did not reach the defined threshold for clinical significance (6 points for FACT-BMT domains and 5 points for SF-36 domains).


CONCLUSIONS
Global QOL scores are similar in patients with isolated oral cGVHD and patients with oral and concomitant extra-oral cGVHD.
Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA.
Joseph
J
DePalo
Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109, USA.
Xiaoyu
X
Chai
Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109, USA.
Stephanie J
SJ
Lee
Hematologic Malignancies, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
Corey S
CS
Cutler
Brigham and Women's Hospital, Division of Oral Medicine and Dentistry, 1620 Tremont Street, Suite BC-3-028, Boston, MA 02120, USA. Electronic address: ntreister@partners.org.
Nathaniel
N
Treister
D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000503:physiopathology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life
Oral chronic graft-versus-host disease; Quality of life; Stem cell transplantation