Assessing the Revised 2014 NIH Criteria for Oral Chronic GVHD

By Patrick Daly - Last Updated: October 11, 2022

The mouth is the second most commonly affected site of chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic cell transplantation (HCT). In an article published in Medicina Oral, Patologia Oral y Cirugia Bucal, researchers evaluated the 2014 revisions to the 2004 National Institutes of Health (NIH) consensus criteria for oral cGVHD and found the NIH criteria were valuable for oral cGVHD diagnosis and severity classification.

The study applied the NIH consensus criteria to data on baseline oral manifestations at the first dental visit of 22 patients diagnosed with oral cGVHD. Oral disease was assessed via an NIH-modified Oral Mucosa Rating Scale (OMRS) and Thongprasom sign score, salivary gland and sclerotic diseases were assessed based on signs and symptoms, and functional impact was assessed by organ-specific severity score.

Among the patients included in the study, median time from HCT to oral cGVHD diagnosis was 11.9 months. The most common oral manifestation was white striae with an erosive area (72.7%), followed by xerostomia (18.2%), superficial mucocele (9.1%), and limited mouth opening (9.1%). Additionally, 90.9% of patients met the criteria for partial limitation of oral intake.

Researchers found no significant differences between NIH-modified OMRS and organ-specific severity score across patient characteristic groups, nor did they find any associations between individual oral manifestations of cGVHD and characteristics among the patients.

Ultimately, the authors found that the 2014 NIH consensus criteria are “informative and feasible in real-world practice,” and they suggested their data will assist future research as a representation of typical clinical characteristics of patients with oral cGVHD.

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