Early oral changes following bone marrow transplantation

Area of Science:

• Oncology
• Hematology
• Oral Medicine

Background:

• Chemoradiotherapy and bone marrow transplantation are intensive treatments with significant side effects.
• Oral complications can severely impact patient quality of life and treatment outcomes.

Purpose of the Study:

• To analyze early oral changes after chemoradiotherapy and bone marrow transplantation.
• To identify the timing, characteristics, and affected oral sites of these changes.
• To explore potential contributing factors and clinical indicators for worsening oral conditions.

Main Methods:

• Prospective assessment of oral changes in patients undergoing chemoradiotherapy and bone marrow transplantation.
• Documentation of mucosal alterations, salivary changes, and patient-reported symptoms.
• Correlation of oral findings with treatment phases and potential etiologies.

Main Results:

• Notable oral changes included mucosal alterations (color, atrophy, vascularity, ulceration), increased salivary viscosity, xerostomia, dryness, and pain.
• Ventral tongue, buccal/labial mucosa, and marginal gingiva were most affected; palate least affected.
• Oral changes began pre-transplant, worsened in the first two weeks post-transplant, and then progressively resolved.

Conclusions:

• Oral changes are a common early consequence of chemoradiotherapy and bone marrow transplantation.
• Contributing factors include conditioning regimens, immunosuppression, xerostomia, trauma, infections (HSV), and acute graft-versus-host disease (GVHD).
• Worsening oral status >21 days post-transplant warrants consideration of oral HSV infection or acute GVHD.