口腔慢性移植物抗宿主病的治疗：一项回顾性队列研究。
Treatment of oral chronic graft-versus-host disease: a retrospective cohort study.
机构信息
Divisão de Pesquisa Clínica, Instituto Nacional de Câncer - INCA, Rio de Janeiro, RJ, Brazil.
Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil.
出版信息
Einstein (Sao Paulo). 2021 Oct 29;19:eAO6177. doi: 10.31744/einstein_journal/2021AO6177. eCollection 2021.
OBJECTIVE
The aim of this study was to evaluate patients with complete response of oral chronic graft-versus-host disease to immunosuppressive treatment.
METHODS
A total of 29 patients submitted to allogeneic hematopoietic stem cell transplantation, with oral chronic graft-versus-host disease, were enrolled in this retrospective study, from September 2012 to February 2018. Patients were treated with combined topical dexamethasone solution and topical tacrolimus ointment, combined topical dexamethasone and topical tacrolimus, systemic immunosuppressive medication, and topical dexamethasone only.
RESULTS
The mean time of complete response of lichenoid lesions, erythema, and ulcers using dexamethasone and systemic immunosuppressive medication was of 105, 42 and 42 days, respectively (p=0.013).When we associated dexamethasone, tacrolimus and systemic immunosuppressive medication, the mean time of complete response of lichenoid lesions, erythema and ulcers was of 91,84 and 77 days (p=0.011). When dexamethasone was used alone, the mean time of complete response of lichenoid lesions, erythema and ulcers was 182, 140, 21 days, respectively (p=0.042).
CONCLUSION
Our study shows that lichenoid lesions require more time to heal. Notably, lichenoid lesions tend to respond better to dexamethasone combined with tacrolimus and systemic immunosuppressive medication, whereas erythema and ulcers respond better to dexamethasone combined with systemic immunosuppressive medication and dexamethasone only, respectively.
目的
本研究旨在评估接受免疫抑制治疗的口腔慢性移植物抗宿主病完全缓解患者的疗效。
方法
回顾性分析 2012 年 9 月至 2018 年 2 月期间 29 例接受异基因造血干细胞移植后出现口腔慢性移植物抗宿主病的患者。患者接受联合局部地塞米松溶液和局部他克莫司软膏、联合局部地塞米松和局部他克莫司、全身免疫抑制药物以及仅局部地塞米松治疗。
结果
地塞米松联合全身免疫抑制药物治疗后，苔藓样病变、红斑和溃疡完全缓解的平均时间分别为 105、42 和 42 天（p=0.013）。当我们联合使用地塞米松、他克莫司和全身免疫抑制药物时，苔藓样病变、红斑和溃疡完全缓解的平均时间分别为 91、84 和 77 天（p=0.011）。当单独使用地塞米松时，苔藓样病变、红斑和溃疡完全缓解的平均时间分别为 182、140 和 21 天（p=0.042）。
结论
本研究表明，苔藓样病变的愈合时间更长。值得注意的是，地塞米松联合他克莫司和全身免疫抑制药物治疗苔藓样病变效果更好，而红斑和溃疡则分别对地塞米松联合全身免疫抑制药物和地塞米松治疗反应更好。
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