Oral cancer after prolonged immunosuppression for multiorgan chronic graft-versus-host disease

Rev Bras Hematol Hemoter. 2014;36(1):65-8. doi: 10.5581/1516-8484.20140016.

Abstract

Long-term survivors of hematopoietic stem cell transplantation are recognized as a risk group for malignization. Malignant oral neoplasms are increasingly being reported in the literature as a consequence of lesions of chronic graft-versus-host disease, and prolonged multidrug treatment to control its manifestations. This report describes a 43-year-old patient who, after allogeneic bone marrow transplantation, developed an oral squamous cell carcinoma secondary to the use of azathioprine, cyclosporine, prednisone, and tacrolimus, associated with multiorgan chronic graft-versus-host disease involving the oral mucosa, skin, eyes, and liver. This report aims to discuss the possible role of immunosuppressant therapy for chronic graft-versus-host disease on the development of oral squamous cell carcinoma, and the relevance of a close oral follow-up of patients to detect dysplastic or malignant alterations at an early stage.

Keywords: Bone marrow transplantation; Graft-versus-host disease; Leukemia; Mouth neoplasms; Myeloid.