Orofacial Characteristics of Sclerodermatous Chronic Graft-Versus-Host Disease

By Dustin Samples - February 22, 2023

After allogeneic hematopoietic stem cell transplantation (HSCT), chronic graft-versus-host disease (cGHVD) can manifest in several sites, but the most frequently affected is the orofacial cavity. One of the most debilitating manifestations of orofacial cGVHD is the sclerodermatous variety. At the 2023 Tandem Transplant & Cellular Therapy Meetings of the ASTCT and CIBMTR, a research team presented their observations of the characteristics and management of sclerodermatous cGVHD in patients treated at a single treatment center.

This retrospective descriptive study included patients who received allogeneic HSCT from 1993-2017 at a single treatment center (n=39, median age, 50 years old). The most common features observed were limited mouth opening (n=19) and fibrous banding of the buccal mucosa (n=23). Somewhat common were perioral fibrosis (n=8) and focal gingival recession (n=4).

Management for limited mouth opening included jaw-stretching exercises, which either maintained or improved mouth opening for 6 of the 10 patients who performed the exercises. Other management strategies included surgery and intralesional triamcinolone injections.

“Management options are limited but may be effective,” the authors observed; though, the treatment sample sizes were small, with only 2 patients having received injections and 3 patients having undergone surgery.

The team noted, “While oral sclerodermatous cGVHD may develop in the context of diffuse cutaneous sclerodermatous cGVHD, the mouth can be the only site affected,” which was the case for approximately 50% of the patients in their study.

Treister N, Bajonaid A, Guntaka PK, et al. Characterization of Orofacial Features Associated with Sclerodermatous Chronic Graft-Versus-Host Disease. Abstract #365. Presented at the 2023 Tandem Meetings of ASTCT and CIBMTR; February 15-19, 2023; Orlando, FL.

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