Hyposalivation and salivary gland histopathology in graft-versus-host disease.

Introduction: A major long-term complication following allogeneic hematopoietic cell transplantation (HCT) is graft-versus-host disease (GVHD). Oral chronic GVHD (cGVHD) is common and affects the mucosa with diagnostic lichenoid-like manifestations. Distinctive features such as hyposalivation and inflammatory histopathology of the salivary glands have been associated with both transplant regimen and GVHD. We retrospectively explored the association of hyposalivation and minor salivary gland (MSG) histopathology with the establishment and progression of GVHD. Methods: A total of 791 patient records were screened, and patients were included if salivary flow measurements were registered or if the biopsies contained both oral mucosal and MSG histopathology for comparison. In total, 63 unstimulated saliva and 123 stimulated saliva measurements were analyzed using the Kruskal-Wallis test with Results: Myeloablative conditioning had a significant impact on hyposalivation post-HCT ( Discussion: There is limited evidence to suggest that all patients develop hyposalivation due to oral or extra-oral GVHD. MSG and oral mucosal immunopathology showed strong correlation in histopathological severity and CD8 infiltration at onset, suggesting a common initiation response. However, no correlation was found thereafter, favoring different pathophysiologies.