22 August 2011
Significant oral graft-versus-host disease after allogeneic stem cell transplantation with the FLU/MEL conditioning regimenSamuel VokurkaABDEF, Tomas SvobodaBE, Michal KarasBE, Vladimir KozaA, Pavel JindraE, Dmitry KazakovEF, Ludmila BoudovaBDE
Med Sci Monit 2011; 17(9): CR480-484
Background: Oral graft-versus-host disease (GVHD) is a significant complication after allogeneic stem cell transplantation (SCT) and there is no consistent information about its characteristics in patients after reduced-intensity conditioning regimen FLU/MEL (fludarabine 120 mg/m2 and melphalan 140mg/m2).
Material/Methods: This was a single-centre prospective observational study of patients after allogeneic SCT with FLU/MEL conditioning performed during the period 1/2005-12/2007. Characteristics of oral GVHD were observed in 71 patients. The observation was discontinued due to death, donor lymphocyte infusion (DLI) or new chemotherapy administration.
Results: In 10/2010, the median duration of the observation of the cohort of the patients was 13 (0.2–69) months, and 42 (35–69) months in the still-ongoing 20/71 (28%) patients. Oral acute GVHD had sporadic 7% incidence, whereas oral chronic GVHD was observed in 33% of patients and persisted with median duration of 188 (11–665) days. Clinical and histopathological features were similar in both acute and chronic oral GVHD and included mucosal lichenoid changes, erythema, ulcerations and pseudomembranes, satellite necrosis, apoptotic bodies and lichenoid interface inflammation.
Conclusions: It is necessary to consider complex clinical symptomatology and pathological correlations when classifying the oral GVHD, because local oral symptoms and histopathological features in both acute and chronic oral GVHD forms can be similar. Even though the oral chronic GVHD was mild in the majority of patients, it can be considered as clinically significant due to its incidence, duration and symptomatology. The FLU/MEL conditioning regimen should not be considered as low-risk protocol in this context.
Keywords: Stem Cell Transplantation - adverse effects, Mouth Diseases - pathology, Melphalan - therapeutic use, Graft vs Host Disease - pathology, Chronic Disease, Transplantation Conditioning - adverse effects, Transplantation, Homologous, Vidarabine - therapeutic use, young adult
01 May 2023 : EditorialEditorial: Twenty Years On from Sequencing the Human Genome, Personalized/Precision Oncology Prepares to Meet the Challenges of Checkpoint Inhibitor Therapy
Med Sci Monit 2023; 29:e940911
28 May 2023 : Database AnalysisScientometric and Visualized Analysis of Intravoxel Incoherent Motion Magnetic Resonance Imaging: 1988-2021
Med Sci Monit In Press; DOI: 10.12659/MSM.938715
25 May 2023 : Database AnalysisThe COVID-19 Crisis and the Incidence of Alcohol-Related Deaths in Poland
Med Sci Monit In Press; DOI: 10.12659/MSM.940904
25 May 2023 : Review articleA Review of Preclinical and Clinical Studies in Support of the Role of Non-Steroidal Anti-Inflammatory Drug...
Med Sci Monit In Press; DOI: 10.12659/MSM.940635
25 May 2023 : Clinical ResearchPeriapical Lesions and Missed Canals in Endodontically Treated Teeth: A Cone-Beam Computed Tomographic Stud...
Med Sci Monit In Press; DOI: 10.12659/MSM.940533
Most Viewed Current Articles
13 Nov 2021 : Clinical ResearchAcceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical ResearchRetrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review articleA Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...
Med Sci Monit 2022; 28:e936292
01 Jan 2022 : EditorialEditorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...
Med Sci Monit 2022; 28:e935952