Narrow‐band UVB phototherapy for management of oral chronic graft‐versus‐host disease

Objectives Oral chronic graft‐versus‐host disease (c GVHD ) is a debilitating complication following allogeneic hematopoietic cell transplantation. The objective of this study was to evaluate the safety and efficacy of intraoral narrow‐band ultraviolet B ( NB‐UVB ) phototherapy in the management of oral c GVHD . Methods Patients with oral c GVHD were treated using a custom NB‐UVB unit for a course of 24 phototherapy sessions. Treatments were initiated at 50 mJ/cm 2 and increased by 10% at each visit unless toxicity was noted. Toxicity and response were assessed weekly. Results Eleven patients received a median of 22 (range 4–39) NB‐UVB treatments; 5 patients completed 24 treatments and elected to receive a median of 7 additional treatments. Median symptom scores (0–10) for sensitivity, pain, and dryness at baseline/end of therapy were 7.5, 3, 1, and 3, 1, 2, respectively. Taking into account all patient‐reported outcomes, 7/11 patients had improvement and 2/11 worsened. At least partial improvement was reported in 8/11 patients with none reporting worsening. Overtreatment occurred in 10/11 patients with all graded mild or moderate and resolving in 1–2 days. Conclusions Intraoral NB‐UVB may be effective for management of refractory oral cGVHD . Further optimization of treatment parameters, as well as minimal erythema dose testing, and inclusion of a control arm are necessary in the consideration of future studies.