Oral chronic GVHD after allogeneic stem cell transplantation without total body irradiation performed at a young age

Abstract

Purpose Long-term survivors (LTSs) of allogeneic hematopoietic stem cell transplantation (allo-HCT) may experience oral long-term effects like chronic graft-versus-host disease (oral cGVHD). The aim of this study was to investigate oral cGVHD in patients treated at a young age (< 30 years) more than 5 years after allo-HCT without total body irradiation (TBI). Methods All 94 participants went through a semi-structured interview, and an oral examination. Diagnosis of oral cGVHD was based on the “National Institutes of Health (NIH) cGVHD diagnosis and staging consensus criteria” from 2014. Results Mean age at transplantation was 17.5 years (range 0.4–29.9 years), and mean time since transplantation was 16.7 years (range 6–26 years). Oral cGVHD was diagnosed in 26 (28%) of 94 LTSs. Of which 20 (21.5%) showed lichen planus-like (LPL) changes, and additionally six (6.5%) also fulfilled the diagnostic criteria of oral cGVHD since they had one or more distinctive signs and symptoms of oral cGVHD combined with definite cGVHD in another organ. No LTSs reported oral cGVHD (NIH) grade 3. There was a significant association between cGVHD in the oral cavity and cGVHD in another organ (77% vs 29%, p < 0.001). Out of 72 LTSs, who answered the questions regarding taste disturbances, 16 (22%) reported dysgeusia. No LTSs developed secondary malignancies in the oral cavity during follow-up time. Conclusion Oral long-term effects, such as oral cGVHD, may persist for many years after allo-HCT without TBI-conditioning in patients treated at a young age.

Oral complications in a paediatric graft versus host disease (GVHD) clinic: A retrospective study

“…Previous studies on oral manifestations in paediatric allogeneic bone marrow transplant recipients. Previous have reported on oral complications in patients following allogeneic HSCT (Bhatt et al, 2022;Bollero et al, 2018;Sholkamy et al, 2022;Tanem et al, 2022;Vignon et al, 2017), though the oral health in paediatric HSCT survivors has rarely been described (Chow et al, 2016;Effinger et al, 2014;Nicolatou-Galitis et al, 2001;Treister et al, 2005). Boer et al showed that oral mucosal cGVHD was the most common finding post-allogeneic HSCT (n = 35; 55.7%) in their cohort of patients, followed by xerostomia and pain (n = 34; 98.7%), mouth pain (n = 18; 29.5%) and difficulty in swallowing (n = 8; 13.1%), respectively (Boer et al, 2010).…”