TREATMENT OF ORAL CHRONIC GRAFT-VS-HOST DISEASE WITH DEXAMETHASONE AND TACROLIMUS: A RETROSPECTIVE STUDY

Abstract

Objective The aim of this study was to evaluate the treatment of oral chronic graft-vs-host disease (cGVHD) with topical dexamethasone, topical tacrolimus, and immunosuppressive medication. Study Design This is a retrospective study that evaluated 30 patients who had undergone allogeneic hematopoietic stem cell transplantation (HSCT), with oral cGVHD, from September 2012 to February 2017. The patients were evaluated and treated by 3 investigators by the National Institutes of Health (NIH) scores from diagnosis until healing. The patients were treated with combined topical dexamethasone solution 0.1 mg/mL (0.01%) and topical tacrolimus ointment 0.1%; combined topical dexamethasone; topical tacrolimus and immunosuppressive medication; and topical dexamethasone only. Results The mean time of healing of lichenoid changes, erythema, and ulceration using dexamethasone associated with the immunosuppressive medication was of 105, 42, and 52.5 days, respectively (P = .017). When we associated dexamethasone, tacrolimus, and immunosuppressive medication, the mean time of healing of lichenoid changes, erythema, and ulceration was 98, 35, and 73.5 days, respectively (P = .044). When only dexamethasone was only, the mean time of healing of lichenoid changes, erythema, and ulceration was 182, 140, and 21 days, respectively (P = .022). Conclusions We can conclude that we had a better outcome in patients who were treated with association of dexamethasone, tacrolimus, and immunosuppressive medication, and erythema has a better response than compared with lichenoid changes and ulceration.