Abstract
OBJECTIVES: To characterize and compare the clinical manifestations of oral chronic graft-versus-host disease (cGVHD) in patients with malignant hematopoietic disorders versus those with non-malignant hematopoietic disorders, and to analyze associated risk factors. MATERIALS AND METHODS: Detailed examinations of the oral cavity were conducted in patients with malignant hematopoietic disorders (n = 52) and non-malignant hematopoietic disorders (n = 56) who developed oral cGVHD following allogeneic hematopoietic stem cell transplantation (allo-HSCT). The severity of oral cGVHD was scored, and logistic regression analysis was employed to identify risk factors for oral cGVHD (n = 261). RESULTS: The incidence of oral cGVHD in patients with malignant hematopoietic disorders was significantly higher compared to those with non-malignant hematopoietic disorders (51.49% vs 35.00%, P = 0.01). Additionally, a significantly greater proportion of patients with malignant hematopoietic disorders had an oral lesion score exceeding 5 compared to patients with non-malignant hematopoietic disorders (17/52 vs 7/56, P < 0.0001). The median time from transplantation to the onset of oral cGVHD was earlier in patients with malignant hematopoietic disorders than in patients with non-malignant hematopoietic disorders (6 months vs 7 months, P = 0.001). Furthermore, female donors to male recipients [OR = 1.926, 95% CI (1.07, 3.442), P = 0.027] emerged as an independent risk factor for oral cGVHD. CONCLUSION: Compared to patients with non-malignant hematopoietic disorders, those with malignant hematopoietic disorders exhibit a higher incidence of complications following allo-HSCT. Additionally, patients with malignant hematopoietic disorders experience a more rapid disease onset and are at a greater risk of developing severe oral cGVHD. Furthermore, female donors to male recipients represents a significant risk factor for oral cGVHD but not associated with diagnoses with benign and malignant blood disorders. CLINICAL RELEVANCE: This study elucidates the distinct characteristics of oral cGVHD in patients with malignant hematopoietic disorders and non-malignant hematopoietic disorders, providing valuable insights for developing more precise and personalized clinical treatment strategies for these patients.