Oral lesions in paediatric patients with graft-versus-host disease

This work aims at assessing and describing the most frequent clinical manifestations of the Graft-versus-Host Disease (GvHD) in the oral and maxillofacial region in paediatric patients affected by neoplastic or non neoplastic haematologic disorders undergo specific hematopoietic stem cell transplantation (HSCT) protocols, with a view to detecting the potential pathological modifications which are recognised as the cause of a possible altered harmonious development of the child. Thirty-eight paediatric patients aged between 3 and 13 who underwent hematopoietic stem cell transplantation for neoplastic or non neoplastic haematological disorders were assessed on the basis of their medical history and accurate clinical and instrumental exams, in order to make a correct diagnosis, preliminarily assess oral conditions, detect possible oral pathological manifestations and evaluate their incidence both locally and in terms of clinical severity, as well as to mitigate associated symptoms. This was done to prevent and eliminate any oral interference in the systemic treatment protocol. In line with the data presented in the Literature, clinical GvHD manifestations seem to mainly involve the oral and maxillofacial region from an early phase also in paediatric patients. As a consequence, a timely diagnosis and a multidisciplinary treatment programme are essential to get to an early detection of the oral signs of potential systemic complications, to improve the quality of life of these young patients, as well as to prevent any potential alterations of dentoskeletal development and growth in the child.