Gomes Alessandra Oliveira Ferrari, Torres Sandra Regina, Maiolino Angelo, Dos Santos Cesar Werneck Noce, Silva Junior Arley, Correa Maria Elvira Pizzigatti, Moreira Maria Cláudia Rodrigues, Gonçalves Lucio de Souza
Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil ; Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil.
Rev Bras Hematol Hemoter. 2014;36(1):43-9. doi: 10.5581/1516-8484.20140012.
Chronic graft-versus-host disease is a serious complication of allogeneic hematopoietic cell transplantation, and the mouth is one of the affected sites.
The aim of this study was to evaluate the oral features of this disease after hematopoietic cell transplantation.
This was a cross-sectional multicenter study that enrolled patients submitted to transplantation. Oral evaluations used the National Institutes of Health criteria, salivary flow rates, and the range of mouth opening. Pain and xerostomia were evaluated through a visual analogue scale. Patients were divided into two groups based on the transplantation time (up to one year and more than one year).
Of the 57 evaluated recipients, 44 had chronic graft-versus-host disease: ten (22.72%) in the group with less than one year after transplantation, and 34 (77.27%) in the group with more than one year after transplantation. Lichenoid/hyperkeratotic plaques, erythematous lesions, xerostomia, and hyposalivation were the most commonly reported oral features. Lichenoid/hyperkeratotic plaques were significantly more common in patients within the first year after the transplant. The labial mucosa was affected more in the first year. No significant changes occurred in the frequency of xerostomia, hyposalivation, and reduced mouth opening regarding time after transplantation.
Oral chronic graft-versus-host disease lesions were identified early in the course of the disease. The changes observed in salivary gland function and in the range of mouth opening were not correlated with the time after transplantation.
慢性移植物抗宿主病是异基因造血细胞移植的一种严重并发症,口腔是受累部位之一。
本研究旨在评估造血细胞移植后该疾病的口腔特征。
这是一项横断面多中心研究,纳入接受移植的患者。口腔评估采用美国国立卫生研究院标准、唾液流速和开口度。通过视觉模拟量表评估疼痛和口干情况。根据移植时间(一年以内和一年以上)将患者分为两组。
在57名接受评估的受者中,44人患有慢性移植物抗宿主病:移植后不到一年的组中有10人(22.72%),移植后一年以上的组中有34人(77.27%)。苔藓样/角化过度斑块、红斑性病变、口干和唾液分泌减少是最常报告的口腔特征。苔藓样/角化过度斑块在移植后第一年内的患者中明显更常见。第一年唇黏膜受累更严重。移植后时间方面,口干、唾液分泌减少和开口度降低的频率没有显著变化。
口腔慢性移植物抗宿主病病变在疾病过程中早期即可发现。唾液腺功能和开口度方面观察到的变化与移植后时间无关。