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01.02.2012 | Original Article

Professional oral health care reduces oral mucositis and febrile neutropenia in patients treated with allogeneic bone marrow transplantation

verfasst von: Haruhiko Kashiwazaki, Takae Matsushita, Junichi Sugita, Akio Shigematsu, Kumiko Kasashi, Yutaka Yamazaki, Takashi Kanehira, Satoshi Yamamoto, Takeshi Kondo, Tomoyuki Endo, Junji Tanaka, Satoshi Hashino, Mitsufumi Nishio, Masahiro Imamura, Yoshimasa Kitagawa, Nobuo Inoue

Erschienen in: Supportive Care in Cancer | Ausgabe 2/2012

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Abstract

Goal of work

Little is known about the effects of professional oral health care (POHC) on the outcome of hematopoietic stem cell transplantation (HSCT). We evaluated the effects of POHC given by dentists and dental hygienists on the development of oral mucositis and febrile neutropenia (FN) after allogeneic bone marrow transplantation (BMT).

Patients and methods

We retrospectively studied 140 adult patients who had received allogeneic BMT, with or without POHC, in our hospital consecutively between February 2002 and December 2009. Oral mucositis was evaluated according to the World Health Organization scale.

Main results

The incidence of oral mucositis was 66.7% (52/78) in the patients who had received POHC, compared to 93.5% (58/62) in the non-POHC group (P < 0.001). The incidence of FN and the maximal level of CRP were also significantly lower in the POHC group. Multivariate analysis revealed that the POHC was significantly associated with the incidence of oral mucositis (odds ratio, 7.58; 95%CI, 2.45–23.34; P < 0.001).

Conclusions

We concluded that POHC reduced the incidences of oral mucositis and FN by upgrading the overall oral hygiene during HSCT.

Donnelly JP, Muus P, Schattenberg A, De Witte T, Horrevorts A, DePauw BE (1992) A scheme for daily monitoring of oral mucositis in allogeneic BMT recipients. Bone Marrow Transplant 9:409–413PubMed

Blijlevens NM, Donnelly JP, De Pauw BE (2000) Mucosal barrier injury: biology, pathology, clinical counterparts and consequences of intensive treatment for haematological malignancy: an overview. Bone Marrow Transplant 25:1269–1278PubMedCrossRef

Wardley AM, Jayson GC, Swindell R, Morgenstern GR, Chang J, Bloor R, Fraser CJ, Scarffe JH (2000) Prospective evaluation of oral mucositis in patients receiving myeloablative conditioning regimens and haemopoietic progenitor rescue. Br J Haematol 110:292–299PubMedCrossRef

Dodd MJ, Dibble S, Miaskowski C, Paul S, Cho M, MacPhail L, Greenspan D, Shiba G (2001) A comparison of the affective state and quality of life of chemotherapy patients who do and do not develop chemotherapy-induced oral mucositis. J Pain Symptom Manage 21:498–505PubMedCrossRef

Scully C, Sonis S, Diz PD (2006) Oral mucositis. Oral Dis 12:229–241PubMedCrossRef

Gruber U, Fegg M, Buchmann M, Kolb HJ, Hiddemann W (2003) The long-term psychosocial effects of haematopoietic stem cell transplantation. Eur J Cancer Care (Engl) 12:249–256

Sonis ST, Oster G, Fuchs H, Bellm L, Bradford WZ, Edelsberg J, Hayden V, Eilers J, Epstein JB, LeVeque FG, Miller C, Peterson DE, Schubert MM, Spijkervet FK, Horowitz M (2001) Oral mucositis and the clinical and economic outcomes of hematopoietic stem-cell transplantation. J Clin Oncol 19:2201–2205PubMed

Sonis ST (2004) Oral mucositis in cancer therapy. J Support Oncol 2:3–8PubMed

Rubenstein EB, PetersonDE SM, Keefe D, McGuire D, Epstein J, Elting LS, Fox PC, Cooksley C, Sonis ST (2004) Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer 100(9 Suppl):2026–2046PubMedCrossRef

10.

Keefe DM, Schubert M, Elting LS, Sonis ST, Epstein J, Raber-Durlacher JE, Migliorati CA, McGuire D, Hutchins RD, Peterson DE (2007) Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer 109:820–831PubMedCrossRef

11.

Elad S, Garfunkel AA, Or R, Michaeli E, Shapira MY, Galili D (2003) Time limitations and the challenge of providing infection-preventing dental care to hematopoietic stem-cell transplantation patients. Support Care Cancer 11:674–677PubMedCrossRef

12.

Yeager KA, Webster J, Crain M, Kasow J, McGuire DB (2000) Implementation of an oral care standard for leukemia and transplantation patients. Cancer Nurs 23:40–47PubMedCrossRef

13.

Melkos AB, Massenkeil G, Arnold R, Reichart PA (2003) Dental treatment prior to stem cell transplantation and its influence on the posttransplantation outcome. Clin Oral Investig 7:113–115PubMedCrossRef

14.

Toubai T, Tanaka J, Mori A et al (2004) Efficacy of etoposide, cyclophosphamide, and total body irradiation in allogeneic bone marrow transplantation for adult patients with hematological malignancies. Clin Transplant 18:552–557PubMedCrossRef

15.

Shigematsu A, Kondo T, Yamamoto S et al (2008) Excellent outcome of allogeneic hematopoietic stem cell transplantation using a conditioning regimen with medium-dose VP-16, cyclophosphamide and total-body irradiation for adult patients with acute lymphoblastic leukemia. Biol Blood Marrow Transplant 14:568–575PubMedCrossRef

16.

Masaoka T (2004) Evidence-based recommendations for antimicrobial use in febrile neutropenia in Japan: executive summary. Clin Infect Dis 39:49–52CrossRef

17.

Spielberger R, Stiff P, Bensinger W et al (2004) Palifermin for oral mucisitis after intensive therapy for hematologic cancers. N Engl J Med 351:2590–2598PubMedCrossRef

18.

Fanning SR, Rybicki L, Kalaycio M et al (2004) Severe mucositis is associated with reduced survival after autologous stem cell transplantation for lymphoid malignancies. Br J Haematol 135:374–381CrossRef

19.

Ohbayashi Y, Imataki O, Ohnishi H, Iwasaki A, Ogawa T, Inagaki N, Shigeta H, Ohue Y, Tasaka T, Kitanaka A, Kubota Y, Tanaka T, Ishida T, Miyake M (2008) Multivariate analysis of factors influencing oral mucositis in allogeneic hematopoietic stem cell transplantation. Ann Heamatol 87:837–845CrossRef

20.

Velden WJFM, Blijlevens NMA, Feuth T, Donnely JP (2009) Febrile mucositis in haematopoietic SCT recipients. Bone Marrow Transplant 43:55–60PubMedCrossRef

21.

Shigematsu A, Yamamoto S, Sugita J, Kondo T et al (2010) Increased risk of bacterial infection after engraftment in patients treated with allogeneic bone marrow transplantation following reduced-intensity conditioning regimen. Transplant Infect Dis 12(5):412–420CrossRef

22.

Adachi M, Ishihara K, Abe S, Okuda K (2007) Professional oral health care by dental hygienists reduces respiratory infections in elderly persons requiring nursing care. Int J Dent Hygiene 5:69–74CrossRef

23.

Bondi E, Baroni C, Prete A, Gatti M, Carrassi A, Lodi G, Porter SR (1997) Local antimicrobial therapy of oral mucositis in paediatric patients undergoing bone marrow transplantation. Oral Oncol 33:322–326PubMedCrossRef

24.

Ferretti GA, Ash RC, Brown AT, Largent BM, Kaplan A, Lillich TT (1987) Chlorhexidine for prophylaxis against oral infections and associated complications in patients receiving bone marrow transplants. J Am Dent Assoc 114:461–467PubMed

25.

Weisdorf DJ, Bostrom B, Raether D, Mattingly M, Walker P, Pihlstrom B, Ferrieri P, Haake R, Goldman A, Woods W et al (1989) Oropharyngeal mucositis complicating bone marrow transplantation: prognostic factors and the effect of chlorhexidine mouth rinse. Bone Marrow Transplant 4:89–95PubMed

26.

Foote RL, Loprinzi CL, Frank AR, O’Fallon JR, Gulavita S, Tewfik HH, Ryan MA, Earle JM, Novotny P (1994) Randomized trial of a chlorhexidine mouthwash for alleviation of radiationinduced mucositis. J Clin Oncol 12:2630–2633PubMed

27.

Pihlstrom BL, Michalowicz BS, Johnson NW (2005) Periodontal diseases. Lancet 366:1809–1820PubMedCrossRef

28.

Landa AS, van der Mei HC, Busscher HJ (1997) Detachment of linking film bacteria from enamel surfaces by oral rinses and penetration of sodium lauryl sulphate through an artificial oral biofilm. Adv Dent Res 11:528–538PubMedCrossRef

29.

Hellstrom MK, Ramberg P, Krok L, Lindhe J (1996) The effect of supragingival plaque control on the subgingival microflora in human periodontitis. J Clin Periodontol 23:934–940PubMedCrossRef

30.

Yoneyama T, Yoshida M, Matsui T, Sasaki H, Group Oral Care Working (1999) Oral care and pneumonia. Lancet 354:515PubMedCrossRef

31.

Yoneyama T, Yoshida M, Ohrui T et al (2002) Oral care reduces pneumonia in older patients in nursing homes. J Am Geriatr Soc 50:430–433PubMedCrossRef

32.

Yoneyama T, Hashimoto K, Fukuda H, Ishida M, Arai H, Sekizawa K, Yamaya M, Sasaki H (1996) Oral hygiene reduces respiratory infections in elderly bed-bound nursing home patients. Arch Gerontol Geriatr 22:11–19PubMedCrossRef

33.

Adachi M, Ishihara K, Abe S, Okuda K, Ishikawa T (2002) Effect of professional oral health care on the elderly living in nursing homes. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94:191–195PubMedCrossRef

34.

Abe S, Ishihara K, Okuda K (2001) Prevalence of potential respiratory pathogens in the mouths of elderly patients and effects of professional oral care. Arch Gerontol Geriatr 32:45–55PubMedCrossRef

35.

Abe S, Ishihara K, Adachi M, Sasaki H, Tanaka K, Okuda K (2006) Professional oral health reduces influenza infection in elderly. Arch Gerontol Geriatr 43:157–164PubMedCrossRef

Titel: Professional oral health care reduces oral mucositis and febrile neutropenia in patients treated with allogeneic bone marrow transplantation
verfasst von: Haruhiko Kashiwazaki
Takae Matsushita
Junichi Sugita
Akio Shigematsu
Kumiko Kasashi
Yutaka Yamazaki
Takashi Kanehira
Satoshi Yamamoto
Takeshi Kondo
Tomoyuki Endo
Junji Tanaka
Satoshi Hashino
Mitsufumi Nishio
Masahiro Imamura
Yoshimasa Kitagawa
Nobuo Inoue
Publikationsdatum: 01.02.2012
Verlag: Springer-Verlag
Erschienen in: Supportive Care in Cancer / Ausgabe 2/2012
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-011-1116-x

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Professional oral health care reduces oral mucositis and febrile neutropenia in patients treated with allogeneic bone marrow transplantation