Topical cyclosporin A for treatment of oral chronic graft-versus-host disease.

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.