Bone marrow transplantation: graft versus host disease and oral changes

PURPOSE: This study aimed to evaluate the prevalence of oral changes and their association with graft versus host disease (GVHD) in patients undergoing bone marrow transplantation (BMT). METHODS: The sample consisted of 51 BMT patients. A questionnaire was used to collect data on age, gender, disease, type and time of transplant, cell origin, and GVHD occurrence. The extraoral and intraoral clinical examinations were performed by specialized professionals. RESULTS: Systemic GVHD was observed in 32.5% of the allogeneic transplant patients, and all of the patients with GVHD had oral manifestations. There was a statistically significant association between systemic GVHD and oral manifestations (P<0.001). CONCLUSION: Given the relatively high prevalence of oral changes associated with GVHD in patients undergoing BMT, this study confirms the need to consider dental aspects in the examination, diagnosis, treatment and prognosis of possible complications after BMT.

[1]  H. Kashiwazaki,et al.  Efficacy of folinic acid in preventing oral mucositis in allogeneic hematopoietic stem cell transplant patients receiving MTX as prophylaxis for GVHD , 2012, Bone Marrow Transplantation.

[2]  S. Tarima,et al.  Amelioration of oral mucositis pain by NASA near-infrared light-emitting diodes in bone marrow transplant patients , 2012, Supportive Care in Cancer.

[3]  Y. Yamazaki,et al.  Professional oral health care reduces oral mucositis and febrile neutropenia in patients treated with allogeneic bone marrow transplantation , 2012, Supportive Care in Cancer.

[4]  C. Marchetti,et al.  Multiple squamous cell carcinomas of the oral cavity in a young patient with graft-versus-host disease following allogenic bone marrow transplantation. , 2011, International journal of oral and maxillofacial surgery.

[5]  K. Stevenson,et al.  Oral epithelial dysplasia and squamous cell carcinoma following allogeneic hematopoietic stem cell transplantation: clinical presentation and treatment outcomes , 2011, Bone Marrow Transplantation.

[6]  S. Elad,et al.  Validation of the National Institutes of Health (NIH) scale for oral chronic graft-versus-host disease (cGVHD). , 2010, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[7]  V. Lara,et al.  Quantitative analysis of Langerhans' cells in oral chronic graft-vs.-host disease. , 2008, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[8]  Paul J. Martin,et al.  Biology of chronic graft-versus-host disease: implications for a future therapeutic approach. , 2008, The Keio journal of medicine.

[9]  D. McGuire,et al.  Clinical Practice Guidelines for the Prevention and Treatment of Mucositis , 2007 .

[10]  M. GORDÓN-NÚÑEZ,et al.  Prevention of oral lesions in children with acute lymphoblastic leukemia. , 2006, International journal of pediatric otorhinolaryngology.

[11]  Y. Ueyama,et al.  Immunohistopathological study of the oral lichenoid lesions of chronic GVHD. , 2006, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[12]  D. McGuire,et al.  Clinical practice guidelines for the prevention and treatment of cancer therapy–induced oral and gastrointestinal mucositis , 2004, Cancer.

[13]  C. Ulrich,et al.  Predictors of oral mucositis in patients receiving hematopoietic cell transplants for chronic myelogenous leukemia. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[14]  J. Epstein,et al.  Oral candidiasis in hematopoietic cell transplantation patients: an outcome-based analysis. , 2003, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[15]  R. Arnold,et al.  Dental treatment prior to stem cell transplantation and its influence on the posttransplantation outcome , 2003, Clinical Oral Investigations.

[16]  R. Storb,et al.  Comparison of chronic graft-versus-host disease after transplantation of peripheral blood stem cells versus bone marrow in allogeneic recipients: long-term follow-up of a randomized trial. , 2002, Blood.

[17]  M. Al-Mohaya,et al.  Oral fungal colonization and oral candidiasis in renal transplant patients: the relationship to Miswak use. , 2002, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[18]  F. Spijkervet,et al.  Oral mucositis and the clinical and economic outcomes of hematopoietic stem-cell transplantation. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  S. Grafakos,et al.  The oral manifestations of chronic graft-versus-host disease (cGVHD) in paediatric allogeneic bone marrow transplant recipients. , 2001, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[20]  E. Kansu,et al.  Late complications of hematopoietic stem cell transplantation , 2001 .