title: Photobiomodulation therapy in the management of chronic oral graft-versus-host disease.
abstract: Patients treated with allogeneic hematopoietic stem cell transplantation (HSCT) may experience oral complications associated with chronic graft-versus-host disease (cGVHD). These complications may significantly affect quality of life, even many years post-HSCT. Current treatment options for oral cGVHD are limited and often include steroid or other immunomodulatory medications, which may not adequately control the oral condition. A non-immunosuppressive intervention for symptomatic relief in oral cGVHD would thus be a welcome addition to the treatment paradigm.
  
  
  
  We report seven cases of oral cGVHD that were treated with photobiomodulation therapy (PBM), previously known as low-level laser therapy (LLLT). Patients underwent at least two PBM treatments per week in addition to local treatment with steroids, and if on systemic therapies, these were either unchanged or dosage was reduced during the period of PBM therapy. Follow-up data is presented for 4 weeks of treatment.
  
  
  
  Oral pain, sensitivity, and dry mouth improved in most patients. These findings suggest PBM therapy may represent an additional approach for management of oral cGVHD, and suggest that controlled studies should be conducted to confirm the efficacy and safety of PBM therapy in oral cGVHD and to determine optimal PBM therapy protocols.
authors.affiliation: Cedars-Sinai Health Center, Los Angeles, CA, 90048, USA. joel.epstein@cshs.org.|City of Hope, Duarte, CA, 91010, USA. joel.epstein@cshs.org.
authors.forename: Joel B
authors.initials: JB
authors.lastname: Epstein
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Center, and Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Judith E
authors.initials: JE
authors.lastname: Raber-Durlacher
authors.affiliation: Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Lill
authors.affiliation: Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Yuliya P L
authors.initials: YP
authors.lastname: Linhares
authors.affiliation: Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Jerry
authors.initials: J
authors.lastname: Chang
authors.affiliation: Division of Oncology, Weill Cornell Medical Center, New York, NY, USA.
authors.forename: Andrei
authors.initials: A
authors.lastname: Barasch
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Center, and Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Romée I C
authors.initials: RI
authors.lastname: Slief
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Margot
authors.initials: M
authors.lastname: Geuke
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Judith A E M
authors.initials: JA
authors.lastname: Zecha
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Center, and Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Dan M J
authors.initials: DM
authors.lastname: Milstein
authors.affiliation: Blood and Marrow Transplant, University of California, San Diego, San Diego, CA, USA.
authors.forename: D
authors.initials: D
authors.lastname: Tzachanis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014184:Transplantation, Homologous / Q000009:adverse effects*
keywords: Hematopoietic stem cell transplantation; Hyposalivation; LLLT; Low-level laser therapy; Oral graft-versus-host disease; PBM therapy; Photobiomodulation therapy; Xerostomia