Treatment of oral chronic graft-versus-host disease: a retrospective cohort study.

Autor: Ramos GA; Divisão de Pesquisa Clínica, Instituto Nacional de Câncer - INCA, Rio de Janeiro, RJ, Brazil., Leite TDB; Divisão de Pesquisa Clínica, Instituto Nacional de Câncer - INCA, Rio de Janeiro, RJ, Brazil., Lobo CB; Divisão de Pesquisa Clínica, Instituto Nacional de Câncer - INCA, Rio de Janeiro, RJ, Brazil., Santos PSDS; Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil., Moreira MCR; Centro de Transplante de Medula Óssea, Instituto Nacional de Câncer - INCA, Rio de Janeiro, RJ, Brazil., Antunes HS; Divisão de Pesquisa Clínica, Instituto Nacional de Câncer - INCA, Rio de Janeiro, RJ, Brazil.
Jazyk: English; Portuguese
Zdroj: Einstein (Sao Paulo, Brazil) [Einstein (Sao Paulo)] 2021 Oct 29; Vol. 19, pp. eAO6177. Date of Electronic Publication: 2021 Oct 29 (Print Publication: 2021).
DOI: 10.31744/einstein_journal/2021AO6177
Abstrakt: Objective: The aim of this study was to evaluate patients with complete response of oral chronic graft-versus-host disease to immunosuppressive treatment.
Methods: A total of 29 patients submitted to allogeneic hematopoietic stem cell transplantation, with oral chronic graft-versus-host disease, were enrolled in this retrospective study, from September 2012 to February 2018. Patients were treated with combined topical dexamethasone solution and topical tacrolimus ointment, combined topical dexamethasone and topical tacrolimus, systemic immunosuppressive medication, and topical dexamethasone only.
Results: The mean time of complete response of lichenoid lesions, erythema, and ulcers using dexamethasone and systemic immunosuppressive medication was of 105, 42 and 42 days, respectively (p=0.013).When we associated dexamethasone, tacrolimus and systemic immunosuppressive medication, the mean time of complete response of lichenoid lesions, erythema and ulcers was of 91,84 and 77 days (p=0.011). When dexamethasone was used alone, the mean time of complete response of lichenoid lesions, erythema and ulcers was 182, 140, 21 days, respectively (p=0.042).
Conclusion: Our study shows that lichenoid lesions require more time to heal. Notably, lichenoid lesions tend to respond better to dexamethasone combined with tacrolimus and systemic immunosuppressive medication, whereas erythema and ulcers respond better to dexamethasone combined with systemic immunosuppressive medication and dexamethasone only, respectively.
Databáze: MEDLINE
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