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Chronic oral graft-versus-host disease: induction and maintenance therapy with photobiomodulation therapy

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Abstract

Abstract

This study presents follow-up of a prior study of patients with chronic symptomatic oral chronic graft-versus-host-disease (cGVHD) managed with photobiomodulation therapy (PBM therapy for 1 month. Here, we report long-term follow-up of a series of patients where PBM therapy in patients with oral cGVHD for maintenance follows the initial period of PBM therapy for continuing management.

Patients and methods

We report continuing follow-up of 7 cases of oral cGVHD that were treated with PBM therapy. PBM therapy was continued in these patients with the goal of determining the best management schedule of PBM to maintain or improve control of each patient’s symptoms and signs of oral cGVHD.

Results

Oral sensitivity and mucosal changes of cGVHD were controlled with a continuing schedule of PBM therapy of up to 6–8-week treatment intervals in patients with continuing GVHD. These findings suggest that PBM therapy represents an additional approach for continuing management of oral cGVHD and that the frequency of treatment should be individualized for each patient to provide best control of oral findings. In one case weekly PBM treatment was continued, while in others, management on a monthly or bimonthly basis was associated with control of the oral condition. PBM may be individualized and provided based upon best control of the symptoms and signs of oral GVHD.

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Acknowledgments

The authors acknowledge James Carroll, THOR Photomedicine Ltd., for providing PBM therapy devices and suggestions on PBM therapy parameters used in this case series.

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Authors and Affiliations

  1. City of Hope Comprehensive Cancer Center, Duarte, CA, 91010, USA

    Joel B. Epstein

  2. Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Health Center, Los Angeles, CA, 90048, USA

    Joel B. Epstein

  3. Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, Netherlands

    Judith E. Raber-Durlacher

  4. Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1100 DD, Amsterdam, Netherlands

    Judith E. Raber-Durlacher

  5. Beverly Hills, USA

    Geena L. Epstein

  6. Department of Hematology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands

    Mette D. Hazenberg

  7. Moores Cancer Center, University of California, San Diego, CA, USA

    Dimitrios Tzachanis

  8. City of Hope Comprehensive Cancer Center/Kaiser Permanente, Duarte, CA, 91010, USA

    Ricardo T. Spielberger

Authors
  1. Joel B. Epstein
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  2. Judith E. Raber-Durlacher
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  3. Geena L. Epstein
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Correspondence to Joel B. Epstein.

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Epstein, J.B., Raber-Durlacher, J.E., Epstein, G.L. et al. Chronic oral graft-versus-host disease: induction and maintenance therapy with photobiomodulation therapy. Support Care Cancer 29, 1387–1394 (2021). https://doi.org/10.1007/s00520-020-05626-3

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  • DOI: https://doi.org/10.1007/s00520-020-05626-3

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