Dahllöf G, Heimdahl A, Modéer T, Twetman S, Bolme P, Ringdén O
Department of Pedodontics, School of Dentistry, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden.
Scand J Dent Res. 1989 Jun;97(3):268-77. doi: 10.1111/j.1600-0722.1989.tb01612.x.
Oral mucous membrane lesions were studied in 54 children below 12 yr of age treated with allogeneic bone marrow transplantation mainly because of hematological malignancies. Sixty-two percent of the children exhibited a wide range of oral side effects during therapy. Lesions observed during the first 2 wk prior to engraftment of the donor marrow were related to the chemo- and radiotherapy given. Oral ulcerations were seen in 34% of the children. Children given methotrexate as graft-versus-host disease (GVHD) prophylaxis exhibited oral ulcerations significantly (P less than 0.05) more often than those given cyclosporin. Oral lesions related to acute GVHD were only observed in two patients. Reactivating herpes simplex virus infection was seen in 35% of the children who were seropositive prior to BMT. An extensive oral candidiasis was observed in 15% of the patients. All six children with a chronic GVHD exhibited changes in the oral mucosa 2-4 yr after transplantation such as erythma of the mucous membranes, tongue atrophy and also lichenoid changes in the buccal mucosa.
对54名主要因血液系统恶性肿瘤接受异基因骨髓移植的12岁以下儿童的口腔黏膜病变进行了研究。62%的儿童在治疗期间出现了广泛的口腔副作用。在供体骨髓植入前的前2周观察到的病变与化疗和放疗有关。34%的儿童出现口腔溃疡。接受甲氨蝶呤作为移植物抗宿主病（GVHD）预防的儿童口腔溃疡的发生率明显（P小于0.05）高于接受环孢素的儿童。仅在两名患者中观察到与急性GVHD相关的口腔病变。35%在骨髓移植前血清学阳性的儿童出现复发性单纯疱疹病毒感染。15%的患者出现广泛的口腔念珠菌病。所有6名患有慢性GVHD的儿童在移植后2至4年出现口腔黏膜变化，如黏膜红斑、舌萎缩以及颊黏膜的苔藓样改变。
