ORAL TOXICITY/ COMPLICATIONS FOLLOWING BONE MARROW TRANSPLANTS

骨髓移植后的口腔毒性/并发症

• 批准号: 3795007
• 负责人: M SCHUBERT
• 金额: --
• 依托单位: FRED HUTCHINSON CANCER RESEARCH CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3795007
• 关键词: bone marrow transplantation; cancer complication; cancer pain; combination cancer therapy; disease /disorder proneness /risk; drug adverse effect; gender difference; graft versus host disease; human age group; human subject; neoplasm /cancer chemotherapy; neoplasm /cancer radiation therapy; oral bacteria; oral facial pain; oral health; oral pharyngeal disorder; oral pharyngeal disorder diagnosis; radiobiology; statistics /biometry; tobacco abuse

Oral Complications are not only a major cause of pain and suffering for patients undergoing marrow transplantation (BMT), but can also contribute to systemic complications and fatality. Many factors cause or influence the severity of BMT oral complications, including chemoradiotherapy conditioning regimens, oral infections, and acute and chronic GVHD. Little is known about which factors acting singly or in combination are most damaging to oral tissues; the clinical recognition and diagnosis of some complications is unclear, the types and frequency of risks associated with the presence of these complications has yet to be determined. There have been no reported studies on how acute GVHD is manifested in the mouth. Oral acute GVHD frequently goes undetected or is misdiagnosed which can result in delayed diagnosis, compromise overall patient management and lead to increased suffering and risk of other complications. Similar problems exist for oral toxicities resulting from chemoradiotherapy and from oral microbial colonization and infection. We will examine factors likely to influence the frequency and severity of oral complications following BMT. These will include; a) patient-related factors such as patient age, disease, previous therapy, pretransplant oral health, numbers and types of dental restorations and appliances, and oral habits (including smoking) and b) BMT-related factors such as the type and dosage of agents used in BMT conditioning regimens, the use of biological response modifiers, post-BMT immunosuppressive therapy, the rate of engraftment, oral microbial colonization and types of infections, including viral infections, and acute GVHD. The investigators will study these factors through a) the review of prior medical records and medical history, b) frequent detailed clinical examinations, and c) specific laboratory (pathology, microbiology, chemistry, etc.) data. They expect to: a) determine the contribution various risk factors make to the various oral complications observed; b) develop useful diagnostic criteria for diagnosing oral complications of BMT; and c) thus determine oral complication risk profiles for patients. Besides facilitating more expeditious diagnosis of oral complications, these studies will aid in the design of oral care protocols to more efficiently and effectively prevent and/or manage oral problems. They will also enhance understanding of how oral complications can cause or influence systemic complications following BMT.

口腔并发症不仅是造成疼痛和痛苦的主要原因 接受骨髓移植（BMT）的患者，但也可以做出贡献 导致全身并发症和死亡。 许多因素造成或影响 BMT 口腔并发症的严重程度，包括放化疗 调理方案、口腔感染以及急性和慢性 GVHD。 小的 已知哪些因素单独或组合作用最重要 损害口腔组织；某些疾病的临床识别和诊断 并发症尚不清楚，相关风险的类型和频率 这些并发症的存在尚未确定。 有 目前尚无关于急性 GVHD 如何在口腔中表现的研究报道。 口腔急性 GVHD 经常未被发现或被误诊，这可能会导致 导致诊断延迟，损害整体患者管理并导致 增加痛苦和其他并发症的风险。 类似问题 存在因放化疗和口服引起的口服毒性 微生物定植和感染。 我们将研究可能的因素 影响 BMT 后口腔并发症的发生频率和严重程度。 这些将包括； a) 患者相关因素，例如患者年龄， 疾病、既往治疗、移植前口腔健康、数量和类型 牙齿修复和矫治器以及口腔习惯（包括吸烟）和 b) BMT相关因素，例如BMT所用药物的类型和剂量 调理方案、生物反应调节剂的使用、BMT 后 免疫抑制治疗、植入率、口腔微生物 定植和感染类型，包括病毒感染和急性感染 移植物抗宿主病。 研究人员将通过以下方式研究这些因素：a) 审查 先前的医疗记录和病史，b) 频繁的详细临床 检查，以及 c) 特定实验室（病理学、微生物学、 化学等）数据。 他们期望： a) 确定贡献 各种危险因素导致观察到的各种口腔并发症； b) 制定有用的诊断标准来诊断口腔并发症 骨髓移植； c) 从而确定患者的口腔并发症风险状况。 除了促进口腔并发症的更快速诊断之外， 这些研究将有助于设计更多的口腔护理方案 高效且有效地预防和/或管理口腔问题。 他们会 还可以增强对口腔并发症如何导致或影响的了解 BMT 后的全身并发症。