Oral involvement in chronic graft-versus-host disease after allogeneic bone marrow transplantation

Nakamura, Seiji; Hiroki, Akiko; Shinohara, Masanori; Gondo, Hisashi; Ohyama, Yukiko; Mouri, Takefumi; Sasaki, Makoto; Shirasuna, Kanemitsu; Harada, Mine; Niho, Yoshiyuki

doi:10.1016/s1079-2104(96)80203-4

Cited by 70 publications

(70 citation statements)

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“…The histological features that have been reported to be associated with cGVHD on MSG are lobular and periductal lymphocytic infiltrate, acinar atrophy/destruction, and fibrosis. [10][11][12] Horn et al 18 in 1995, proposed a system for mucosal and salivary gland cGVHD diagnosis and grading. After comprehensive discussions among HSCT experts, the NIH consensus criteria for Relative area (PAS þ area/total MSG area).…”

Section: Discussionmentioning

confidence: 99%

“…In fact, oral cGVHD often coexists with cutaneous, hepatic or ocular cGVHD. 25 According to Nakamura et al, 10 the histological alterations in MSG can reflect the cGVHD status. 10 Ductal dilation has been described as one of the histological findings for cGVHD diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…25 According to Nakamura et al, 10 the histological alterations in MSG can reflect the cGVHD status. 10 Ductal dilation has been described as one of the histological findings for cGVHD diagnosis. [10][11][12]18 However, it could only be the consequence of acinar atrophy and fibrosis due to the conditioning regimen.…”

Section: Discussionmentioning

confidence: 99%

“…10 Ductal dilation has been described as one of the histological findings for cGVHD diagnosis. [10][11][12]18 However, it could only be the consequence of acinar atrophy and fibrosis due to the conditioning regimen. In fact, no significant differences were found in the degree of ductal dilation, comparing patients who developed cGVHD and those who did not.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9] The typical histological findings of cGVHD in salivary glands are periductal and diffuse lobular lymphocyte infiltrate (CD8 þ over CD4 þ ), atrophy or destruction of acini, and fibrosis. 5,[10][11][12][13][14][15] Despite the advent of new therapies and management of cGVHD, minimal changes in this scenario have been observed, mainly due to an incomplete understanding of the pathogenesis of this disorder. 1,16 Knowing the most important histological findings for the diagnosis of minor salivary gland (MSG) cGVHD and its possible influence on overall patient health and understanding the mononuclear subset participation in salivary glands after HSCT can contribute to better management of those patients.…”

Section: Introductionmentioning

confidence: 99%

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The impact of morphological and immunohistological changes in minor salivary glands on the health of the oral cavity in HSCT patients

Soares

Corrêa

Cintra

et al. 2013

Bone Marrow Transplant

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The objective of this study was to test the relationship between histological changes in minor salivary glands (MSG) and chronic GVHD (cGVHD) severity and OS of hematopoietic SCT (HSCT) patients, and to discriminate the participation of events preceding HSCT that damage MSG, from those linked to cGVHD. The MSG of 57 HSCT patients who were divided into two groups-oral cGVHD (36 cases) and non-cGVHD (21 cases)-were compared with the MSG of a control group of 19 non-HSCT individuals. cGVHD changes were assessed according to National Institutes of Health (NIH) consensus and the systems of Horn et al. Acinar areas and mononuclear cell subsets were set through morphometry. Horn's 'periductal lymphocytic infiltrate' correlated with an extensive form of cGVHD and NIH 'periductal lymphocytes with exocytosis into duct' correlated with global survival. Measurements of the acinar area differed between the three groups, being the lowest in cGVHD patients, but also reduced in non-cGVHD patients. Significant differences among CD45, CD45RO, CD4 and CD8 immunomarked cells/mm 2 were found by comparing the two groups of HSCT patients. In brief, periductal lymphocytic infiltrate and exocytosis implies inflammatory activity and, consequently, might reflect the cGVHD status and influence survival. Acini loss in non-cGVHD patients may be due to pre-transplant events, but massive lymphocyte infiltrate is part of the cGVHD process.

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Section: Discussionmentioning

confidence: 99%