Clinical Research Division, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil.
Bone and Marrow Transplant Center, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil.
Photobiomodul Photomed Laser Surg. 2020 Nov;38(11):683-686. doi: 10.1089/photob.2020.4878. Epub 2020 Oct 23.
Acute graft-versus-host disease (GVHD) in the oral cavity is a rare complication of hematopoietic stem cell transplantation (HSCT) and treatment has a varying length of time for wound healing. This case report present a 63-year-old female patient with a diagnosis of acute lymphoid leukemia, submitted a related allogeneic HSCT, which after 6 months evolved with oral acute GVHD, presenting odynophagia, dysphagia, and difficulty of hygiene. We started the mouthwash dexamethasone and nystatin oral suspension and five sessions of photobiomodulation therapy (PBMT) (660 nm, 100 mW, 0.028 cm, 2 J, 70 J/cm, 20 sec/point) has been used with daily applications in the oral cavity (at the lesion sites and in healthy areas). Complete healing of the oral lesions was observed in 5 days although the patient had acute skin and gastrointestinal GVHD. The treatment of oral acute GVHD with PBMT is still rare in the literature, but due to a good result in wound healing with PBMT, we have used this therapeutic option in combination with dexamethasone and have been successful in healing and reducing pain.
口腔急性移植物抗宿主病（GVHD）是造血干细胞移植（HSCT）的罕见并发症，其治疗时间因伤口愈合而异。本病例报告介绍了一位 63 岁女性患者，诊断为急性淋巴细胞白血病，接受了相关的同种异体 HSCT，6 个月后出现口腔急性 GVHD，表现为咽痛、吞咽困难和口腔卫生困难。我们开始使用口腔洗必泰加制霉菌素混悬液漱口，并进行了 5 次光生物调节疗法（PBMT）（660nm，100mW，0.028cm，2J，70J/cm，20 秒/点），每天在口腔内（病变部位和健康区域）应用。尽管患者患有急性皮肤和胃肠道 GVHD，但口腔病变在 5 天内完全愈合。PBMT 治疗口腔急性 GVHD 在文献中仍较为罕见，但由于 PBMT 在伤口愈合方面有较好的效果，我们已将这种治疗选择与地塞米松联合使用，并成功治愈并减轻了疼痛。
