GVHD Flashcards
What does GVHD stand for?
Graft Versus Host Disease
What type of transplant commonly causes GVHD?
Allogeneic bone marrow transplant (BMT)
What causes GVHD?
Donor T cells attack recipient’s tissues due to HLA mismatch
What are two main types of GVHD?
Acute and Chronic
When does acute GVHD occur?
Within 100 days post-transplant
When does chronic GVHD occur?
After 100 days post-transplant (commonly 3–12 months)
What oral symptoms suggest chronic GVHD?
Reticular white striae, erythematous background, mucosal ulceration, xerostomia
What medication is this patient taking that increases GVHD risk?
Systemic prednisone and methotrexate
What are the differential diagnoses for oral lesions in GVHD?
Oral Hairy Leukoplakia (OHL), Oral Lichen Planus (OLP), Trauma
What does the lateral tongue show in chronic GVHD?
Reticular white striae on erythematous background, poorly demarcated
What is a common location for OHL?
Lateral borders of the tongue
What virus is associated with OHL?
Epstein-Barr virus (EBV)
What is the appearance of OHL?
White, hairy, corrugated plaque that cannot be wiped off
What distinguishes GVHD from OHL in histology?
GVHD mimics lichen planus; OHL has ballooning epithelial cells
How is chronic GVHD diagnosed?
Clinical + confirmed with biopsy if uncertain
What condition must be ruled out before diagnosing GVHD?
Oral lichen planus, OHL, trauma
What is the most common symptom patients report with oral GVHD?
Burning sensation or pain
What topical treatment can relieve GVHD symptoms?
Topical corticosteroids or anesthetics
Which topical immunosuppressive agents may help GVHD?
Tacrolimus, PUVA, Psoralen
How is xerostomia managed in GVHD?
Saliva substitutes, Pilocarpine, sialogogues, frequent sips of water
What oral hygiene measures are advised for GVHD patients?
Alcohol-free mouthwash, fluoridated toothpaste, good diet
Why should systemic steroids be considered before dental treatment?
Risk of adrenal insufficiency; may need steroid cover
What is ANC and why is it important in GVHD dental care?
Absolute Neutrophil Count; guides antibiotic need and safety for procedures
What ANC level allows elective treatment without antibiotics?
ANC > 1000/mm3
What ANC level requires delaying elective treatment or giving antibiotics?
ANC 500-1000/mm3
What ANC level contraindicates elective dental treatment?
ANC <500/mm3 cubic millimeter
What antibiotic is given for prophylaxis if not allergic?
Amoxicillin 50 mg/kg
What post-op advice is given for GVHD patients?
Use chlorhexidine rinse and syringe irrigation for healing
Why are GVHD patients at high risk after surgery?
Delayed healing, immunosuppression, high infection risk
What systemic signs may indicate chronic GVHD?
Xerostomia, arthritis, dysphagia, scleroderma-like symptoms
What are features of acute GVHD?
Rash, mucosal ulcers, diarrhea, liver enzyme elevation
What organs can chronic GVHD affect?
Liver, eyes, skin, esophagus, GI tract, salivary glands
