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Published on: March 17, 2020
MASCC/ISOO Clinical Practice Statement: Management of oral manifestations of chronic graft-versus-host-disease
Yehuda Zadik1,2, Judith E Raber-Durlacher3,4, Joel B Epstein5,6
1Department of Oral Medicine, Faculty of Dental Medicine, The Hebrew University of Jerusalem, and Hadassah-University Medical Center, P.O.B. 12272, 9112002, Jerusalem, Israel. yehuda.zadik@mail.huji.ac.il.
Purpose:
A MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise tool for clinicians, which concentrates practical information needed for the management of oral complications of cancer patients. This CPS is focused on the management of oral manifestations of chronic graft-versus-host-disease (cGVHD).
Methods:
This CPS was developed based on critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets and table to generate a short manual about the best standard of care.
Results:
The treatment goals in oral cGVHD are to relieve pain and xerostomia, improve oral function, prevent secondary infection, prevent deterioration of the dentition, and detect malignant transformation as early as possible. The prevention and treatment measures for oral mucosal lesions, hypofunction of the salivary glands, and sclerodermatous changes in the oral and perioral tissues are detailed, as well as the possible complications and side effects of these interventions.
Conclusions:
Patients post allogeneic hematopoietic cell transplantations, with cGVHD manifest in the oral and perioral tissues, should be regularly monitored and treated as needed by an oral care practitioner. This CPS provides the clinician with practical tools for examining, preventing, and treating the various sequalae that may affect the oral cavity in these patients.
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