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Life sciences · Journal article
Journal of Bone Marrow Transplantation and Cellular Therapy · October 7, 2026
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Oral chronic graft-versus-host disease (cGVHD) is a frequent and clinically heterogeneous manifestation after allogeneic hematopoietic cell transplantation (HCT). In addition to lichenoid lesions, erythema, and ulceration, the disease can affect the salivary glands, other tissues, quality of life, and is associated with a risk of oral carcinoma. Then, the objective of this study was to update the Brazilian consensus of the Brazilian Society of Bone Marrow Transplantation (Sociedade Brasileira de Transplante de Medula Óssea—SBTMO) on oral cGVHD (2021). A narrative review was conducted including publications from 2021 onward. Evidence and strength of recommendation was graded according to the 2009 Oxford Center for Evidence- Based Medicine. The final recommendations were defined by a panel of SBTMO experts in cGVHD. The most directly applicable evidence supports the use of topical corticosteroids for symptomatic mucosal disease. Photobiomodulation, intraoral ultraviolet B phototherapy, barrier agents, and platelet lysate are promising local options, but supported mainly by small, uncontrolled studies. Ruxolitinib and belumosudil show signals of oral response in patients with refractory disease, but mouthspecific evidence remains observational, secondary or organ-specific, or partially extrapolated; both should be considered conditional second-line or salvage systemic options. Prolonged oral surveillance is necessary due to the risk of secondary oral cancer and other complications. This Brazilian consensus update supports a multidimensional assessment of oral cGVHD and favors local therapy for localized disease whenever feasible. Systemic therapies should be reserved for selected refractory or multiorgan cases, while prevention of oral complications and long-term surveillance remain integral to care.