Comparison of oral chronic graft-versus-host disease characteristics between patients with malignant and non-malignant hematopoietic disorders.

OBJECTIVES

To characterize and compare the clinical manifestations of oral chronic graft-versus-host disease (cGVHD) in patients with malignant hematopoietic disorders versus those with non-malignant hematopoietic disorders, and to analyze associated risk factors.

MATERIALS AND METHODS

Detailed examinations of the oral cavity were conducted in patients with malignant hematopoietic disorders (n = 52) and non-malignant hematopoietic disorders (n = 56) who developed oral cGVHD following allogeneic hematopoietic stem cell transplantation (allo-HSCT). The severity of oral cGVHD was scored, and logistic regression analysis was employed to identify risk factors for oral cGVHD (n = 261).

RESULTS

The incidence of oral cGVHD in patients with malignant hematopoietic disorders was significantly higher compared to those with non-malignant hematopoietic disorders (51.49% vs 35.00%, P = 0.01). Additionally, a significantly greater proportion of patients with malignant hematopoietic disorders had an oral lesion score exceeding 5 compared to patients with non-malignant hematopoietic disorders (17/52 vs 7/56, P < 0.0001). The median time from transplantation to the onset of oral cGVHD was earlier in patients with malignant hematopoietic disorders than in patients with non-malignant hematopoietic disorders (6 months vs 7 months, P = 0.001). Furthermore, female donors to male recipients [OR = 1.926, 95% CI (1.07, 3.442), P = 0.027] emerged as an independent risk factor for oral cGVHD.

CONCLUSION

Compared to patients with non-malignant hematopoietic disorders, those with malignant hematopoietic disorders exhibit a higher incidence of complications following allo-HSCT. Additionally, patients with malignant hematopoietic disorders experience a more rapid disease onset and are at a greater risk of developing severe oral cGVHD. Furthermore, female donors to male recipients represents a significant risk factor for oral cGVHD but not associated with diagnoses with benign and malignant blood disorders.

CLINICAL RELEVANCE

This study elucidates the distinct characteristics of oral cGVHD in patients with malignant hematopoietic disorders and non-malignant hematopoietic disorders, providing valuable insights for developing more precise and personalized clinical treatment strategies for these patients.