Abstract：
OBJECTIVE: There are limited treatment options available for hematopoietic stem-cell transplant patients (HSCT) with oral graft-versus-host disease (GVHD). Intraoral phototherapy is a novel, yet promising therapeutic regimen.
OBJECTIVE: To assess the safety and effectiveness of intraoral narrowband UVB (nbUVB) phototherapy in the treatment of oral GVHD.
METHODS: This case series evaluated 10 patients with refractory oral GVHD, who were treated at Northwestern Memorial Hospital with nbUVB between July 2019 and October 2023. Primary outcomes were to evaluate the safety and efficacy of phototherapy. Efficacy was measured by objective improvement in symptom scores and subjective improvement in patient reported symptoms. Safety was determined by the withdrawal due to adverse events. Total nbUVB exposure, number of treatments, and change in systemic immunosuppressive medications were also examined.
RESULTS: The study cohort comprised 10 patients who developed oral GVHD at a median of 9.5 months after HSCT. The total median dose of nbUVB was 36 J/cm2, and the median number of sessions was 55. All 10 patients demonstrated some degree of improvement in symptoms. Notably, there was a reduction in the number of patients who reported symptoms of oral pain (83%), bleeding (67%), xerostomia (50%), and oral sensitivity (78%) after initiating phototherapy. There was also a statistically significant decrease in the levels of pain, erythema, and edema (p ≤ 0.001, < 0.001, 0.01, respectively). Most patients tolerated phototherapy well, but 1 patient withdrew from treatment due to adverse effects. Seventy-five percent of patients who were on immunosuppressive medications were able to decrease or stop these medications.
CONCLUSIONS: This case series suggests that nbUVB phototherapy is well tolerated and efficacious in patients with oral GVHD.
OBJECTIVE: To assess the safety and effectiveness of intraoral narrowband UVB (nbUVB) phototherapy in the treatment of oral GVHD.
METHODS: This case series evaluated 10 patients with refractory oral GVHD, who were treated at Northwestern Memorial Hospital with nbUVB between July 2019 and October 2023. Primary outcomes were to evaluate the safety and efficacy of phototherapy. Efficacy was measured by objective improvement in symptom scores and subjective improvement in patient reported symptoms. Safety was determined by the withdrawal due to adverse events. Total nbUVB exposure, number of treatments, and change in systemic immunosuppressive medications were also examined.
RESULTS: The study cohort comprised 10 patients who developed oral GVHD at a median of 9.5 months after HSCT. The total median dose of nbUVB was 36 J/cm2, and the median number of sessions was 55. All 10 patients demonstrated some degree of improvement in symptoms. Notably, there was a reduction in the number of patients who reported symptoms of oral pain (83%), bleeding (67%), xerostomia (50%), and oral sensitivity (78%) after initiating phototherapy. There was also a statistically significant decrease in the levels of pain, erythema, and edema (p ≤ 0.001, < 0.001, 0.01, respectively). Most patients tolerated phototherapy well, but 1 patient withdrew from treatment due to adverse effects. Seventy-five percent of patients who were on immunosuppressive medications were able to decrease or stop these medications.
CONCLUSIONS: This case series suggests that nbUVB phototherapy is well tolerated and efficacious in patients with oral GVHD.
摘要：
目的：造血干细胞移植（HSCT）患者口腔移植物抗宿主病（GVHD）的治疗方案有限。口内光疗是一种新颖的，但有希望的治疗方案。
目的：评估口腔内窄带UVB（nbUVB）光疗治疗口腔GVHD的安全性和有效性。
方法：本病例系列评估了10例难治性口腔GVHD患者，他们在2019年7月至2023年10月期间在西北纪念医院接受nbUVB治疗。主要结果是评估光疗的安全性和有效性。通过症状评分的客观改善和患者报告的症状的主观改善来衡量功效。安全性由不良事件引起的停药决定。nbUVB总暴露量,治疗次数,还检查了全身免疫抑制药物的变化。
结果：研究队列包括10名患者，这些患者在HSCT后中位9.5个月出现口服GVHD。nbUVB的总中位剂量为36J/cm2，中位疗程数为55。所有10例患者均表现出一定程度的症状改善。值得注意的是,报告有口腔疼痛症状的患者数量减少(83%)，出血（67%），口干症（50%），和口腔敏感性（78％）开始光疗后。疼痛水平也有统计学上的显着下降，红斑,和水肿（p≤0.001，<0.001，0.01，分别）。大多数患者对光疗的耐受性很好，但1例患者因不良反应退出治疗.服用免疫抑制药物的患者中有75％能够减少或停止这些药物。
结论：本病例系列提示nbUVB光疗在口服GVHD患者中具有良好的耐受性和有效性。
目的：评估口腔内窄带UVB（nbUVB）光疗治疗口腔GVHD的安全性和有效性。
方法：本病例系列评估了10例难治性口腔GVHD患者，他们在2019年7月至2023年10月期间在西北纪念医院接受nbUVB治疗。主要结果是评估光疗的安全性和有效性。通过症状评分的客观改善和患者报告的症状的主观改善来衡量功效。安全性由不良事件引起的停药决定。nbUVB总暴露量,治疗次数,还检查了全身免疫抑制药物的变化。
结果：研究队列包括10名患者，这些患者在HSCT后中位9.5个月出现口服GVHD。nbUVB的总中位剂量为36J/cm2，中位疗程数为55。所有10例患者均表现出一定程度的症状改善。值得注意的是,报告有口腔疼痛症状的患者数量减少(83%)，出血（67%），口干症（50%），和口腔敏感性（78％）开始光疗后。疼痛水平也有统计学上的显着下降，红斑,和水肿（p≤0.001，<0.001，0.01，分别）。大多数患者对光疗的耐受性很好，但1例患者因不良反应退出治疗.服用免疫抑制药物的患者中有75％能够减少或停止这些药物。
结论：本病例系列提示nbUVB光疗在口服GVHD患者中具有良好的耐受性和有效性。
