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. 2021 Nov;29(11):6353-6360.
doi: 10.1007/s00520-021-06197-7. Epub 2021 Apr 21.

Oral health-related quality of life of patients with oral chronic graft-versus-host disease

Juliette Stolze  1   2 , Marlou Boor  1 , Mette D Hazenberg  3 , Henk S Brand  2 , Judith E Raber-Durlacher  1   4 , Alexa M G A Laheij  5   6
Affiliations

Oral health-related quality of life of patients with oral chronic graft-versus-host disease

Juliette Stolze et al. Support Care Cancer. 2021 Nov.

Abstract

Purpose: Symptoms of oral chronic graft-versus-host-disease (cGVHD) may significantly affect the oral health-related quality of life (OHRQoL). This study aimed to assess the OHRQoL in patients with oral cGVHD and to examine whether oral cGVHD symptoms, mucosal cGVHD, and salivary gland function correlated with OHRQoL.

Methods: Patients referred to the oral cGVHD outpatient clinic were included. Severity of oral mucosal cGVHD, oral cGVHD symptoms, and OHRQoL was assessed by the NIH OMS, NIH OSS, and OHIP-14, respectively. Unstimulated and stimulated whole salivary flow rates were determined and categorized into "hyposalivation," "normal salivary flow," and "hypersalivation."

Results: Of 56 included patients, 80% had mild, moderate, or severe oral mucosal cGVHD. Mean total score of OHRQoL was 16.5 (±11.7), negatively affected by functional problems. Patients reported highest scores regarding oral sensitivity and xerostomia. Significant correlations were found between severity of oral pain and OHRQoL and between oral sensitivity and OHRQoL. No correlation was found between oral mucosal cGVHD and OHRQoL. Patients with hyposalivation, normal salivary flow, and hypersalivation reported equal levels of OHRQoL.

Conclusion: Results demonstrate that the OHRQoL was mostly negatively affected by complaints of oral pain and oral sensitivity and less by the severity of oral mucosal cGVHD assessed by the NIH OMS score. Special attention of (oral) health care professionals for patients with oral cGVHD is mandatory to alleviate their symptoms and improve OHRQoL.

Keywords: GVHD; Hyposalivation; OHIP-14; OHRQoL; Oral chronic-graft-versus-host disease; Quality of life; Xerostomia.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Frequency and severity of lichenoid lesions, erythema, ulcers, and mucoceles in patients with oral chronic graft-versus-host disease (cGVHD) as assessed by NIH OMS (n=55)
Fig. 2
Fig. 2
Patient-reported severeness of oral chronic graft-versus-host disease (cGVHD) symptoms as assessed by NIH OSS. Distribution of scores (n=44)
Fig. 3
Fig. 3
Distribution of the salivary flow rate of oral chronic graft-versus-host disease (cGVHD) patients (n=49)
Fig. 4
Fig. 4
Distribution of the scores on the 14 items of the OHIP-14 of oral chronic graft-versus-host disease (cGVHD) patients (n = 56)
See this image and copyright information in PMC

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