Oral Lesions Developed in Post-Hematopoietic Stem Cell Transplant Patients and the Role of Cryogun Cryotherapy.

OBJECTIVE

To investigate the development of oral premalignant and malignant lesions as a major long-term complication following hematopoietic stem cell transplantation.

METHODS

This single-center retrospective study identified 17 patients who developed 26 pathology-confirmed oral premalignant and malignant lesions after hematopoietic stem cell transplantation, with a latency period ranged from 5 months to nearly 18 years.

RESULTS

Twelve high-grade lesions developed in nine patients at a median of 9 years post-hematopoietic stem cell transplantation, most commonly on the tongue. All high-grade lesions were surgically treated, with complete response in most cases. One patient developed nodal disease 9.6 years after surgery, and another experienced local recurrence of moderate dysplasia 2 years post-treatment, which was controlled by cryogun cryotherapy. Most patients had chronic graft-versus-host disease and histories of immunosuppressant therapy. Cryogun cryotherapy was used to treat 10 premalignant lesions across seven patients, involving the tongue, gingiva, and buccal or labial mucosa. This treatment achieved an 80% complete response rate with minimal scarring. Verrucous hyperplasia was the most common diagnosis (n = 9).

CONCLUSIONS

Routine, long-term oral screening is critical for patients after hematopoietic stem cell transplantation. Cryogun cryotherapy shows promise as an effective, minimally invasive option for managing early oral verrucous lesions.