Photobiomodulation Therapy and Dexamethasone in the Management of Oral Acute Graft-Versus-Host Disease: Case Report

Photobiomodul Photomed Laser Surg. 2020 Nov;38(11):683-686. doi: 10.1089/photob.2020.4878. Epub 2020 Oct 23.

Abstract

Background: Acute graft-versus-host disease (GVHD) in the oral cavity is a rare complication of hematopoietic stem cell transplantation (HSCT) and treatment has a varying length of time for wound healing. Objective: This case report present a 63-year-old female patient with a diagnosis of acute lymphoid leukemia, submitted a related allogeneic HSCT, which after 6 months evolved with oral acute GVHD, presenting odynophagia, dysphagia, and difficulty of hygiene. Methods: We started the mouthwash dexamethasone and nystatin oral suspension and five sessions of photobiomodulation therapy (PBMT) (660 nm, 100 mW, 0.028 cm2, 2 J, 70 J/cm2, 20 sec/point) has been used with daily applications in the oral cavity (at the lesion sites and in healthy areas). Results: Complete healing of the oral lesions was observed in 5 days although the patient had acute skin and gastrointestinal GVHD. Conclusions: The treatment of oral acute GVHD with PBMT is still rare in the literature, but due to a good result in wound healing with PBMT, we have used this therapeutic option in combination with dexamethasone and have been successful in healing and reducing pain.

Keywords: bone morrow transplantation; graft-versus-host disease; hematopoietic stem cell transplantation; laser; low-level laser therapy; photobiomodulation; ulcer.

Publication types

  • Case Reports

MeSH terms

  • Dexamethasone / therapeutic use
  • Female
  • Graft vs Host Disease* / drug therapy
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Low-Level Light Therapy*
  • Middle Aged
  • Wound Healing

Substances

  • Dexamethasone