GRAFT-VERSUS-HOST DISEASE (GVHD)

Question 1

CONCEPT

Answer 1

COMMON SEQUELA OF PATIENTS ALLOGENEIC BONE MARROW TRANSPLANTATION OF STEM CELL TRANSPLANTATION (PATIENTS HAVE INCREASED RISK FOR THE DEVELOPMENT OF EPITHELIAL DYSPLASIA AND SQUAMOUS CELL CARCINOMAS)

Question 2

CAUSE

Answer 2

IMMUNOLOGICALLY ACTIVE DONOR T CELLS ATTACKS THE CELLS OF THE HOST ( RESULT IN GVHD)

Question 3

TYPES GVHD

Answer 3

• ACUTE: FIRST 100 DAYS (2-3 WEEKS), RASH, DIARRHEA, NAUSEA, VOMITING, ABDOMINAL PAIN, LIVER DYSFUNCTION
• CHRONIC: BETWEEN 3-12 MONTHS OR AFTER YEARS. MIMIC LICHENOID CHANGES OF THE SKIN/MUCOSA, ARTHRITIS, XEROSTOMIA, XEROPHTHALMIA, MUCOSITIS, DYSPHAGIA

Question 4

ORAL MANIFESTATIONS

Answer 4

• FINE, RETICULAR NETWORK OF WHITE STRIAE (MIMIC LICHEN PLANUS)
• TONGUE, LABIAL MUCOSA, BUCCAL MUCOSA
• ATROPHY AND ULCERATION OF THE ORAL MUCOSA = BURNING SENSATION

Question 5

HISTOLOGICALLY

Answer 5

RESEMBLE ORAL LICHEN PLANUS

Question 6

PREVENT

Answer 6

PATIENTS PREPARING FOR BMT TYPICALLY UNDERGO T CELL DEPLETION OF THE GRAFT AND PROPHYLACTIC TREATMENT WITH IMMUNOSUPPRESSIVE AGENTS, SUCH AS CORTICOSTEROIDS, CYCLOSPORINE, METHOTREXATE, TACROLIMUS

Question 7

TREATMENT

Answer 7

TOPICAL CORTICOSTEROIDS AND TOPICAL ANAESTHETIC AGENTS FOR ORAL ULCERATIONS