Diagnosis, evaluation and management for oral chronic GVHD

Abstract

 The oral cavity is one of the most common target organs in chronic graft versus host disease (cGVHD) following allogeneic hematopoietic stem cell transplantation. The symptoms include lichen planus-like oral mucosal changes, pain, xerostomia, and dysgeusia, which may deteriorate oral health and function, ultimately impairing oral intake and decreasing quality of life. This review outlines oral cGVHD diagnosis, evaluation, and management. The Japanese Society for Transplantation and Cellular Therapy guidelines recommend diagnosis and evaluation based on the criteria proposed by the National Institutes of Health consensus development project. Symptom management should include removing exacerbating factors, such as oral candidiasis and dryness, and practicing strict oral hygiene. Preferably, topical steroid and not general treatment is preferred to avoid attenuating the graft versus leukemia/lymphoma effect.