Abstract
BackgroundChronic Graft-versus-Host Disease (cGVHD) can impact quality of life, especially in patients with oral involvement. Half of the patients with cGVHD do not respond to first-line therapy with corticosteroids and calcineurin inhibitors. Ruxolitinib is effective in steroid-refractory (SR)-cGVHD cases, but the long-term effects of ruxolitinib on the oral mucosa are unknown.Objective(s)This study aims to assess the effect of ruxolitinib on the oral mucosa of SR-cGVHD patients with oral involvement.Materials and methodsAn observational longitudinal patient study was conducted in 53 patients with SR-cGVHD and oral involvement who were treated with ruxolitinib. The baseline condition of the oral mucosa was compared to its condition at 4 and 12 weeks after starting ruxolitinib.ResultsThe overall response was 81% (43/53), with a complete response in 53% (28/53) and partial response in 28% (15/53) after 12 weeks (p < 0.001). Men and patients concurrently using immunosuppressive therapy responded better than women (p = 0.005) and patients with ruxolitinib monotherapy (p = 0.02), respectively. At a longer follow-up (median 20 months), oral symptoms were comparable to the 12-week symptoms (p = 0.78), regardless of ruxolitinib use (p = 0.83).ConclusionRuxolitinib treatment of SR-cGVHD patients with oral involvement was associated with a significant response of the oral manifestations at 12 weeks.Clinical relevanceThe oral mucosa of SR-cGVHD patients is likely to improve after 4 and 12 weeks of ruxolitinib treatment. Symptom severity at baseline does not affect the response of the oral mucosa.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00784-022-04393-1.
Highlights
Oral involvement in patients with chronic Graft-versus-Host Disease after allogeneic hematopoietic stem cell transplantation is a prevalent complication which limits the quality of life of survivors [1, 2]
Between 2014 and 2019, 190 patients had been treated with ruxolitinib for Chronic Graft-versus-Host Disease (cGVHD), of whom 78 patients had oral manifestations of cGVHD (Fig. 1)
This study shows that ruxolitinib is associated with a significant reduction of oral cGVHD in 81% of patients with SR-cGVHD and oral manifestations
Summary
Oral involvement in patients with chronic Graft-versus-Host Disease (cGVHD) after allogeneic hematopoietic stem cell transplantation is a prevalent complication which limits the quality of life of survivors [1, 2]. Chronic Graft-versus-Host Disease (cGVHD) can impact quality of life, especially in patients with oral involvement. Materials and methods An observational longitudinal patient study was conducted in 53 patients with SR-cGVHD and oral involvement who were treated with ruxolitinib. The baseline condition of the oral mucosa was compared to its condition at 4 and 12 weeks after starting ruxolitinib. Conclusion Ruxolitinib treatment of SR-cGVHD patients with oral involvement was associated with a significant response of the oral manifestations at 12 weeks. Clinical relevance The oral mucosa of SR-cGVHD patients is likely to improve after 4 and 12 weeks of ruxolitinib treatment. Symptom severity at baseline does not affect the response of the oral mucosa
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call