Epstein J B, Reece D E
Division of Oral Medicine and Clinical Dentistry, Vancouver General Hospital, British Columbia Cancer Agency, Canada.
Bone Marrow Transplant. 1994 Jan;13(1):81-6.
Graft-versus-host disease (GVHD) following bone marrow transplant is an important cause of morbidity and mortality. Oral involvement in chronic GVHD occurs frequently and occasionally is the manifestation of greatest concern to the patient. Management with systemic immunosuppression is the principal approach to therapy although topical application of corticosteroids may also be beneficial. We evaluated the use of cyclosporin administered as an oral rinse in patients with oral GVHD which remained active despite the prior use of systemic immunosuppression plus topical dexamethasone. Signs and symptoms of ulcerative oral GVHD improved > or = 50% in 7 of 11 patients (64%) treated with the addition of topical cyclosporin A. The topical use of cyclosporin A may represent a useful adjunctive approach in the management of oral GVHD.
骨髓移植后的移植物抗宿主病（GVHD）是发病和死亡的重要原因。慢性GVHD常累及口腔，偶尔是患者最担心的表现。尽管局部应用皮质类固醇也可能有益，但全身免疫抑制治疗是主要的治疗方法。我们评估了在口服GVHD患者中使用环孢素作为口腔含漱液的情况，这些患者尽管先前使用了全身免疫抑制加局部地塞米松，但病情仍处于活动期。在11例接受局部环孢素A治疗的患者中，有7例（64%）溃疡性口腔GVHD的体征和症状改善≥50%。局部使用环孢素A可能是治疗口腔GVHD的一种有用的辅助方法。
