title: Oral chronic GVHD outcomes and resource utilization: a subanalysis from the chronic GVHD consortium.
abstract: OBJECTIVE
  This study evaluated the extent to which oral chronic graft-versus-host disease (cGVHD) consensus assessments are predictive of management across institutions with and without oral medicine (OM) centers, and whether ancillary care guidelines are followed within clinical practice.
  
  
  METHODS
  Longitudinal oral cGVHD data were abstracted from the cGVHD Consortium, and additional mouth-specific management data were analyzed across five transplant centers.
  
  
  RESULTS
  Seventy-nine patients with 656 visits were observed for a median of 7.1 months with one visit per follow-up month. Ancillary therapies for oral cGVHD were prescribed for 67% of patients for a median of 0.46 months (per follow-up month) at OM centers and 0.78 months at non-OM centers. Patients treated with ancillary therapy were more likely to have an National Institutes of Health (NIH) mouth score of ≥1 (P < 0.001, odds ratio: 5.1) and mouth pain (P = 0.01, odds ratio: 2.6). The odds ratios of receiving ancillary therapy from OM experts were higher than transplant physicians (53%; P = 0.03).
  
  
  CONCLUSIONS
  Oral cGVHD consensus assessments corresponding with ancillary therapy use were mouth pain and NIH mouth score, with higher odds ratios of receiving therapy from OM experts. Ancillary care guidelines for oral cGVHD are reflected in academic clinical practice with respect to utilization of recommended prescriptions.
authors.affiliation: Division of Oral Medicine, Brigham and Women's Hospital, Boston, MA, USA.|Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Yuan
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: X
authors.initials: X
authors.lastname: Chai
authors.affiliation: Department of Oral Pathology and Oral Diagnosis, University of São Paulo School of Dentistry, São Paulo, Brazil.
authors.forename: F
authors.initials: F
authors.lastname: Martins
authors.affiliation: Division of Blood and Marrow Transplantation, Stanford University Medical Center, Stanford, CA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Arai
authors.affiliation: Department of Medicine, University of Minnesota, Boston, MA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Arora
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Oral Medicine Ambulatory, Bone Marrow Transplantation Unit, Hematology and Blood Transfusion Center, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: M E
authors.initials: ME
authors.lastname: Correa
authors.affiliation: Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: J
authors.initials: J
authors.lastname: Pidala
authors.affiliation: Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Cutler
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Division of Oral Medicine, Brigham and Women's Hospital, Boston, MA, USA.|Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
authors.forename: N S
authors.initials: NS
authors.lastname: Treister
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D006086:Graft vs Host Disease / Q000628:therapy*; D006295:Health Resources / Q000706:statistics & numerical data; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009059:Mouth Diseases / Q000628:therapy*; D019242:Oral Medicine / Q000379:methods / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D055815:Young Adult
keywords: ancillary therapy; chronic graft-versus-host disease; consensus; guidelines; hematopoietic cell transplantation; oral cavity