Critical Reviews in Oral Biology & Medicine, Vol 8, 201-216, Copyright © 1997 by International & American Associations for Dental Research
Graft-vs.-host disease
S. B. Woo, S. J. Lee and M. M. Schubert
Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Bone marrow transplantation (BMT) is the treatment of choice for many
leukemias, lymphomas, bone marrow failure syndromes, and immunodeficiency
disorders, and is the primary and salvage therapy for many solid
malignancies. With the establishment of national and international marrow
banks, unrelated allogeneic BMT is being performed with increasing
frequency. Graft-vs.-host disease (GVHD) remains a major complication of
allogeneic BMT, occurring in 25% to 70% of patients despite GVHD
prophylaxis, with the skin, gastro-intestinal tract, and liver as primary
target organs. Oral findings are seen in both acute and chronic GVHD. In
acute GVHD, the oral lesions are often painful, erythematous, ulcerative,
and desquamative. In chronic GVHD, they are lichenoid with associated
erythema and ulcerations; additionally, they may be associated with a sicca
syndrome characterized by xerostomia and progressive salivary gland
atrophy. General principles of BMT are discussed, as are systemic and local
therapeutic options for oral GVHD.
