Abstract
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.
MeSH terms
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Adrenal Cortex Hormones / pharmacology
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Adrenal Cortex Hormones / therapeutic use*
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Antifungal Agents / pharmacology
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Antifungal Agents / therapeutic use*
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Antineoplastic Agents / pharmacology
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Antineoplastic Agents / therapeutic use*
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Candidiasis, Oral / drug therapy
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Candidiasis, Oral / immunology
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Chronic Disease
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Dental Caries / drug therapy
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Dental Caries / immunology
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Dental Caries / pathology
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Drug Administration Schedule
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Graft vs Host Disease / complications
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Graft vs Host Disease / diagnosis
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Graft vs Host Disease / drug therapy*
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Graft vs Host Disease / immunology
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Hematopoietic Stem Cell Transplantation / adverse effects*
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Humans
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Immunosuppressive Agents / administration & dosage
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Mouth / drug effects
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Mouth / immunology
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Mouth / pathology
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Mouth Mucosa / drug effects
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Mouth Mucosa / immunology
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Mouth Mucosa / pathology
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Salivary Glands / drug effects
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Salivary Glands / immunology
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Salivary Glands / pathology
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Transplantation, Homologous
Substances
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Adrenal Cortex Hormones
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Antifungal Agents
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Antineoplastic Agents
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Immunosuppressive Agents