Abstract：
BACKGROUND: Chronic graft-versus-host disease (cGVHD) is a serious and common complication of allogeneic hematopoietic cell transplantation (alloHCT). The oral cavity is the second most common site affected by cGVHD. In 2014, the 2005 National Institutes of Health (NIH) consensus criteria were revised to address areas of controversy. The aim of this study was to evaluate the clinical characteristics of oral cGVHD using the 2014 NIH consensus criteria.
METHODS: The baseline data of oral manifestation of patients, who were diagnosed with oral cGVHD, in the first dental visit were analyzed (n=22). The oral mucosal disease was evaluated by NIH modified Oral Mucosa Rating Scale (OMRS) and Thongprasom sign score. The salivary gland disease and sclerotic disease were determined by the presence of signs and symptoms. The functional impact was assessed by the organ-specific severity score.
RESULTS: The median time from transplant to oral cGVHD diagnosis was 11.9 months. White striae with an erosive area was found in 72.7% of the patients. The mean ± SD of NIH modified OMRS was 6.1 ± 3.0. The most common and severely affected site of lichen planus-like features was buccal mucosa. Xerostomia, superficial mucocele and limited mouth opening were found in 18.2%, 9.1%, and 9.1%, respectively, of the patients. Almost all patients (90.9%) had partial limitation of oral intake. There were no significant differences in NIH modified OMRS or organ-specific severity score among the patient characteristic groups. Moreover, there was no association between the oral manifestations of cGVHD and the patient characteristics.
CONCLUSIONS: The most common oral manifestation of cGVHD was white striae with an erosive area of oral mucosal disease, followed by xerostomia, superficial mucocele, and limited mouth opening. The 2014 NIH consensus criteria for diagnostic and severity assessment are informative and feasible in real-world practice.
METHODS: The baseline data of oral manifestation of patients, who were diagnosed with oral cGVHD, in the first dental visit were analyzed (n=22). The oral mucosal disease was evaluated by NIH modified Oral Mucosa Rating Scale (OMRS) and Thongprasom sign score. The salivary gland disease and sclerotic disease were determined by the presence of signs and symptoms. The functional impact was assessed by the organ-specific severity score.
RESULTS: The median time from transplant to oral cGVHD diagnosis was 11.9 months. White striae with an erosive area was found in 72.7% of the patients. The mean ± SD of NIH modified OMRS was 6.1 ± 3.0. The most common and severely affected site of lichen planus-like features was buccal mucosa. Xerostomia, superficial mucocele and limited mouth opening were found in 18.2%, 9.1%, and 9.1%, respectively, of the patients. Almost all patients (90.9%) had partial limitation of oral intake. There were no significant differences in NIH modified OMRS or organ-specific severity score among the patient characteristic groups. Moreover, there was no association between the oral manifestations of cGVHD and the patient characteristics.
CONCLUSIONS: The most common oral manifestation of cGVHD was white striae with an erosive area of oral mucosal disease, followed by xerostomia, superficial mucocele, and limited mouth opening. The 2014 NIH consensus criteria for diagnostic and severity assessment are informative and feasible in real-world practice.
摘要：
背景：慢性移植物抗宿主病（cGVHD）是异基因造血细胞移植（alloHCT）的严重且常见的并发症。口腔是受cGVHD影响的第二常见部位。2014年，对2005年美国国立卫生研究院（NIH）共识标准进行了修订，以解决有争议的领域。这项研究的目的是使用2014年NIH共识标准评估口服cGVHD的临床特征。
方法：患者口腔表现的基线数据，被诊断患有口服cGVHD，在第一次牙科就诊时进行了分析(n=22).通过NIH改良的口腔粘膜评定量表（OMRS）和Thongprasom体征评分对口腔粘膜疾病进行评估。唾液腺疾病和硬化性疾病由体征和症状的存在确定。通过器官特异性严重程度评分评估功能影响。
结果：从移植到口服cGVHD诊断的中位时间为11.9个月。在72.7％的患者中发现了具有侵蚀区域的白色条纹。NIH改良OMRS的平均值±SD为6.1±3.0。扁平苔藓样特征的最常见和严重影响部位是颊粘膜。口干症,在18.2%的人中发现了浅表粘膜膨出和张口受限，9.1%，和9.1%，分别,的病人。几乎所有患者（90.9％）的口服摄入部分受限。在患者特征组之间，NIH改良的OMRS或器官特异性严重程度评分没有显着差异。此外，cGVHD的口腔表现与患者特征之间无关联.
结论：cGVHD最常见的口腔表现是白色纹，有口腔黏膜疾病的糜烂区域，其次是口干症,浅层粘液囊肿，和有限的张嘴。2014年NIH诊断和严重程度评估的共识标准在现实世界的实践中是有用和可行的。
方法：患者口腔表现的基线数据，
结果：从移植到口服cGVHD诊断的中位时间为11.9个月。
结论：cGVHD最常见的口腔表现是白色纹，有口腔黏膜疾病的糜烂区域，
