Epstein Joel B, Raber-Durlacher Judith E, Wilkins Affi, Chavarria Maria-Gabriella, Myint Han
Department of Oral Medicine and Diagnostic Sciences, University of Illinois, and Illinois Masonic Hospital, Chicago, Illinois 60612, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Mar;107(3):301-12. doi: 10.1016/j.tripleo.2008.12.006.
Oral supportive care is critical in the management of patients receiving hematopoietic cell transplantation (HCT). Advances in HCT, such as the use of stem cells isolated from peripheral blood instead of bone marrow, have resulted in more rapid engraftment and thus a shorter duration of pancytopenia. Reduced-intensity conditioning regimens, associated with less toxicity, make HCT available to older patients and patients with comorbidities. These new developments have led to increased transplant rates and an altered spectrum of therapy-related complications, such as mucositis, and to shifts in the prevalence and pattern of occurrence of infections and graft-versus-host disease. The purpose of this paper is to review the main principles of HCT and to update dental providers on new technologies being applied to transplantation that may influence oral complications and oral care.
口腔支持性护理在接受造血细胞移植(HCT)患者的管理中至关重要。造血细胞移植的进展,如使用从外周血而非骨髓中分离的干细胞,已导致更快的植入,从而缩短了全血细胞减少的持续时间。与较低毒性相关的减低强度预处理方案,使老年患者和合并症患者也能接受造血细胞移植。这些新进展导致移植率增加,治疗相关并发症(如粘膜炎)的范围发生改变,感染和移植物抗宿主病的患病率和发生模式也发生了变化。本文的目的是回顾造血细胞移植的主要原则,并向牙科医护人员介绍正在应用于移植的可能影响口腔并发症和口腔护理的新技术。