ORAL CHRONIC GRAFT-VERSUS-HOST DISEASE IN A COVID-19 PATIENT: A CASE REPORT OF A RAPID AND PROGRESSIVE DISEASE

Abstract

Chronic graft-versus-host disease (cGVHD) is a common complication in patients undergoing haploidentical hematopoietic stem cell transplantation (haploHSCT). The aim was to relate a recent case of a rapid and progressive oral cGVHD after COVID-19. A 35-year-old man developed oral cGVHD only in the lips 190 days after haploHSCT for acute myelomonocytic leukemia. COVID-19 was diagnosed 263 days after haploHSCT and 5 days after donor lymphocyte infusion with improvement in his clinical condition after 1 week. Moreover, the patient reported rough changes in oral mucosa in 24 hours. Oral clinical exam showed extensive lichen planus–like changes in the whole oral mucosa in association with xerostomia, leading to a clinical oral cGVHD diagnosis. Both cGVHD and COVID-19 share high levels of inflammatory markers in their physiopathology, including interleukin 6 and TH-17 immune response. COVID-19 could contribute to oral lesions in association with donor lymphocytes.