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Oral chronic graft-versus-host disease: report from the International Consensus Conference on clinical practice in cGVHD

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Abstract

Chronic graft-versus-host disease (cGVHD) is a multi-organ disease that occurs post-hematopoietic stem cell transplantation, with the mouth being one of the most frequently affected organs. In 2009, the German–Austrian–Swiss working party on bone marrow and blood stem cell transplantation held a consensus conference to define clinical management of cGVHD. The consensus conference aimed to summarize the literature on diagnosis and topical treatment options for oral cGVHD and to provide recommendations for clinical practice, including routine dental and oral care as well as monitoring for secondary malignancies and bisphophonate-induced osteonecrosis of the jaw.

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Acknowledgments

The authors would like to thank all participating centers at the conference: Rostock, Hamburg, Tuebingen, Ulm, Münster, Hannover, Wiesbaden, Berlin, Freiburg, Vienna, Duesseldorf, Kiel, Oldenburg, Augsburg, Munich, Dresden, Essen, Cologne, Leipzig, Heidelberg, Mainz, Nantes, Paris, Greifswald, Wuerzburg, Jena, Nuernberg, Erlangen, Linz, Regensburg, and Basel.

Conflict of interest

J. Meier, S.Z. Pavletic, H. Greinix, M. Gosau, H. Bertz, and S.J. Lee have no conflict of interests. D. Wolff and S. Elad are paid research consultants for Dr. Falk Pharma GmbH. S. Elad is an unpaid research consultant for Saliwell Ltd.

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Authors and Affiliations

  1. Department of Cranio-Maxillo-Facial Surgery, University of Regensburg, Regensburg, Germany

    Johannes K.-H. Meier & Martin Gosau

  2. Department of Haematology and Oncology, University of Regensburg, Regensburg, Germany

    Daniel Wolff

  3. Experimental Transplantation and Immunology Branch, Center of Cancer Research, National Cancer Institute, Bethesda, MD, USA

    Steve Pavletic

  4. Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria

    Hildegard Greinix

  5. Department of Haematology and Oncology, Albert Ludwigs University Medical Centre Freiburg, Freiburg, Germany

    Hartmut Bertz

  6. Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Stefanie J. Lee

  7. Department of stem cell transplantation, St. Anna Children’s Hospital, Vienna, Austria

    Ánita Lawitschka

  8. Department of Oral Medicine, The Hebrew University—Hadassah School of Dental Medicine, POB 12272, Jerusalem, 91120, Israel

    Sharon Elad

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  1. Johannes K.-H. Meier
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  2. Daniel Wolff
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  9. Sharon Elad
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Correspondence to Sharon Elad.

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Disclaimer

1. The Working Group has provided this Consensus Paper on oral cGVHD to inform practitioners, patients, and other interested parties. The Consensus Paper is based on a review of the existing data and the clinical observations of an expert task force.

The Consensus Paper is informational in nature and is not intended to set any standards of care. The Working Group cautions all readers that the strategies described in the Consensus Paper are not intended as practice parameters or guidelines and might not be suitable for every, or any, purpose or application. This Consensus Paper cannot substitute for the individual judgment brought to each clinical situation by the patient’s oral medicine specialist or hematologist. As with all clinical materials, the Consensus Paper reflects the science related to cGVHD at the paper’s development, and it should be used with the clear understanding that continued research and practice could result in new knowledge or recommendations. The Working Group makes no express or implied warranty regarding the accuracy, content, completeness, reliability, operability, or legality of information contained within the Consensus Paper, including, without limitation, the warranties of merchantability, fitness for a particular purpose, and non-infringement of proprietary rights. In no event shall the Consensus Panel be liable to the user of the Position Paper or anyone else for any decision made or action taken in reliance on such information.

2. The Working Group wishes to emphasize that the recommendations in this document represent a wide variety of generally accepted current medical practices. Good clinical judgment and individual circumstances should determine appropriate interventions for specific patients.

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Meier, J.KH., Wolff, D., Pavletic, S. et al. Oral chronic graft-versus-host disease: report from the International Consensus Conference on clinical practice in cGVHD. Clin Oral Invest 15, 127–139 (2011). https://doi.org/10.1007/s00784-010-0450-6

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