Clinical assessment of oral mucositis and candidiasis compare to chemotherapic nadir in transplanted patients

Abstract

Oral mucositis is a chief complication in patients undergoing hematopoietic stem cell transplantation (HSCT). It is considered a toxic inflammatory reaction that interferes with the patient's recuperation and quality of life. Oral candidiasis is a common fungal infection observed in dental practice, particularly in immunocompromised patients. The aim of this study was to evaluate the presence of oral mucositis and oral candidiasis in patients who underwent HSCT and their correlation with the chemotherapeutic nadir (lowest possible outcome). We evaluated patients with different diagnoses who underwent HSCT at the Hospital Erasto Gaertner. No chemotherapeutic nadir curves could be associated with mucositis, and patients had different presentations of mucositis. No patient developed oral candidiasis during hospitalization. Together with cell counts, we collected demographic data including age, oral hygiene, habits harmful to health, and the use of oral prostheses. It was observed that patients who smoked cigarettes before hospitalization showed less mucositis, resulting in no feeding problems or other comorbid conditions due to the effect of mucositis. However, the nadir of the chemotherapy curve, in isolation, is not a predictive tool for the appearance (or no appearance) of oral mucositis.

Occurrence and Severity of Oral Mucositis in Brazilian Pediatric Cancer Patients

“…While there is evidence suggesting that chemotherapy may affect blood cells and thereby cause leukopenia and thrombocytopenia [39,40], our data showed no association between the patients' hematological and biochemical parameters and the occurrence of SOM at any timepoint. Studies show that low leukocyte and platelet counts increase the risk of developing mucositis.…”

“…Studies show that low leukocyte and platelet counts increase the risk of developing mucositis. This may be because, once the neutrophil count is reduced, the host immune response becomes less efficient to adequately manage the cytotoxic effects of the chemotherapeutic drug against the oral mucosa [39,40]. Neutropenic patients have a 7.5-fold greater risk of developing OM [6], especially if their leukocyte count is below 9,500 / mm³ [11].…”

Review of Oral Mucositis Studies in Post Stem Cell Transplant Patients

“…(7) Lenfoma, multipl myelom ve lösemi tanılı otolog ve allojenik kemik iliği transplantasyon hastası ile yapılan çalışmada, oral mukozit gelişme durumu incelendiğinde 4 hastada oral mukozit gelişmediği, 15 hastada grad I, 5 hastada grad II, 5 hastada grad III, yalnızca 1 hastada ise grad IV oral mukozit geliştiği görülmüştür. (8) Mukozit, hastanın yaşam kalitesini düşürür, infeksiyon gelişimine zemin oluşturur. Tüm bunlarla birlikte mukozite ilişkin komplikasyonlar hastanede kalış süresini ve hastane maliyetlerini, ağrıyı kontrol etmek için narkotik kullanımını ve parenteral beslenme gereksinimini artırır.…”

Mucosite oral por quimioterapia e qualidade de vida relacionada à saúde de mulheres com câncer de mama

“…Considerando-se que existam fatores de risco associados ao paciente e ao tratamento. Neste estudo, foram avaliados: idade, IMC, saúde bucal, presença de cárie, xerostomia prévia ao tratamento, dor gengival prévia ao tratamento e presença de comorbidades; além de, mielossupressão, uso de droga buco citotóxica e combinação de medicamentos conforme é encontrada na literatura sobre o tema (BARASH; PETERSON, 2003;DODD et al, 1999;McCARTHY et al, 1998;PATUSSI et al, 2014;ROSENTHAL;TROTTI, 2009;SEILER et al, 2014;SONIS, 2009;SONIS et al, 1978;CLARK, 1991;SURESH et al, 2010;WUKETICH;HIENZ;MAROSI, 2012).…”

“…No estudo, é medida pelo relato de duas escovações ou menos por dia, presença de cárie ao exame bucal, sensação referida de xerostomia, embora, tenha sido observada uma discordância entre o discurso da participante e a inspeção. O que requer uma atenção maior da equipe assistencial, visto que, esses fatores separadamente já apresentam repercussão, em conjunto aumentam significativamente a chance de desenvolver mucosite oral e outros eventos adversos (BARASH;PETERSON, 2003;DODD et al, 1999;McCARTHY et al, 1998;PATUSSI et al, 2014;ROSENTHAL;TROTTI, 2009;SEILER et al, 2014;SONIS, 2009;SONIS et al, 1978;CLARK, 1991;SURESH et al, 2010;WUKETICH;HIENZ;MAROSI, 2012).…”