Gabriel Don A, Shea Thomas, Olajida Oludamilola, Serody Jonathan S, Comeau Terrance
Department of Medicine, University of North Carolina School of Medicine, Chapel Hill 27599, USA.
Semin Oncol. 2003 Dec;30(6 Suppl 18):76-83. doi: 10.1053/j.seminoncol.2003.11.040.
Oral mucosal ulceration is a frequent complication in bone marrow transplantation, resulting from epithelial injury caused by cytotoxic chemotherapy and radiation conditioning, as well as from pre-existing infection. Oral mucositis causes pain, interferes with patient nutrition, and can lead to systemic infection and other complications that increase patient morbidity and mortality; this complication also markedly increases the expense of bone marrow transplantation. A variety of interventions have been assessed for preventing oral mucositis or reducing the severity of mucositis and its sequelae. These include meticulous pretransplantation and ongoing mouth care, calcium phosphate solution, near-infrared light and lower-energy laser treatment, interleukin-11, sucralfate, oral glutamine, granulocyte-macrophage colony-stimulating factor rinse, tretinoin, and keratinocyte growth factor; particularly promising results have been observed with use of the cytoprotectant/radioprotectant agent amifostine. Reduction in the severity and duration of oral mucositis and its sequelae in patients undergoing bone marrow transplantation can have a substantial impact on morbidity and mortality and cost of care. Further systematic evaluation of approaches to prevention and management of oral mucositis is necessary to define optimal strategies in the transplantation setting.
口腔黏膜溃疡是骨髓移植中常见的并发症，它由细胞毒性化疗和放疗预处理引起的上皮损伤以及既往感染所致。口腔黏膜炎会引发疼痛，干扰患者营养摄入，并可能导致全身感染及其他并发症，从而增加患者的发病率和死亡率；这种并发症还会显著增加骨髓移植的费用。人们已对多种干预措施进行评估，以预防口腔黏膜炎或减轻其严重程度及其后遗症。这些措施包括细致的移植前及持续的口腔护理、磷酸钙溶液、近红外光和低能量激光治疗、白细胞介素-11、硫糖铝、口服谷氨酰胺、粒细胞-巨噬细胞集落刺激因子漱口液、维甲酸和角质形成细胞生长因子；使用细胞保护剂/辐射保护剂氨磷汀已观察到特别有前景的结果。减轻接受骨髓移植患者口腔黏膜炎的严重程度和持续时间及其后遗症，可对发病率、死亡率和护理费用产生重大影响。有必要对预防和管理口腔黏膜炎的方法进行进一步系统评估，以确定移植环境中的最佳策略。
