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World J Stomatol. May 20, 2015; 4(2): 96-102
Published online May 20, 2015. doi: 10.5321/wjs.v4.i2.96
Oral graft vs host disease: An immune system disorder in hematopoietic cell transplantation
Paulo Sérgio da Silva Santos, Cassia Maria Fischer Rubira, Héliton Spíndola Antunes, Fabio Luiz Coracin, Cristiane Miranda França
Paulo Sérgio da Silva Santos, Cassia Maria Fischer Rubira, Stomatology Department, Bauru School of Dentistry, University of São Paulo, Bauru 17012-901, São Paulo, Brazil
Héliton Spíndola Antunes, Instituto Nacional de Câncer (INCA), Rio de Janeiro 20230-130, RJ, Brazil
Fabio Luiz Coracin, Cristiane Miranda França, Universidade Nove de Julho, São Paulo 01504-001, SP, Brazil
Author contributions: da Silva Santos PS designed research; da Silva Santos PS, Rubira CMF, Antunes HS, and Coracin FL performed research and analyzed data; da Silva Santos PS, Rubira CMF, Antunes HS, Coracin FL and França CM wrote the paper.
Conflict-of-interest: We do not have any conflict of interest with this paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Paulo Sérgio da Silva Santos, DDS, MD, PhD, Assistant Professor, Stomatology Department, Bauru School of Dentistry, University of São Paulo, Al. Dr. Octávio Pinheiro Brisolla, 9-75, Bauru 17012-901, São Paulo, Brazil. paulosss@fob.usp.br
Telephone: +55-14-32358000 Fax: +55-14-32358000
Received: October 8, 2014
Peer-review started: October 10, 2014
First decision: December 3, 2014
Revised: December 17, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: May 20, 2015
Abstract

Graft vs host disease (GVHD) is a complication of patients who are treated by hematopoietic cell transplantation. National Institutes of Health in 2005 by Working Group on Diagnosis and Staging Consensus Development Project on Criteria for Clinical Trials in Chronic GVHD (cGVHD) established 2 principal categories of oral GVHD, acute and chronic. The oral mucosa may be the first site of manifestation of the disease. Clinical diagnosis needs to be confirmed by a biopsy of oral mucosa and minor salivary glands. Microscopic results have played a major role in the diagnosis and management of acute and chronic oral GVHD. Development of second malignancies is the greatest risk of oral cGVHD patients, mostly regarding squamous cell carcinoma. The focus of oral GVHD therapy is to improve symptoms and maintain oral function. The aim of this review article is to update the information on the oral GVHD in its clinical, microscopic features and their complications.

Keywords: Stem cell transplantation, Graft vs host disease, Mouth mucosa, Diagnosis, Oral, Salivary glands

Core tip: Graft vs host disease (GVHD) patients are susceptible to recurrent and deadly infections due to immune system harm. Chemotherapy treatment may cause a range of complications, such as neuropathic pain resulting from vincristine adverse effects, overgrowth of gingival due to cyclosporine and effects on bones and teeth growth and development during childhood and youth. Oral GVHD patients must have follow-ups due to risks of oral infections, bleeding, and cancerous developments.