Advances in hematologic stem cell transplant: an update for oral health care providers.
Oral supportive care is critical in the management of patients receiving hematopoietic cell transplantation (HCT). Advances in HCT, such as the use of stem cells isolated from peripheral blood instead of bone marrow, have resulted in more rapid engraftment and thus a shorter duration of pancytopenia. Reduced-intensity conditioning regimens, associated with less toxicity, make HCT available to older patients and patients with comorbidities. These new developments have led to increased transplant rates and an altered spectrum of therapy-related complications, such as mucositis, and to shifts in the prevalence and pattern of occurrence of infections and graft-versus-host disease. The purpose of this paper is to review the main principles of HCT and to update dental providers on new technologies being applied to transplantation that may influence oral complications and oral care.
Epstein
Joel B
JB
Department of Oral Medicine and Diagnostic Sciences, University of Illinois, and Illinois Masonic Hospital, Chicago, Illinois 60612, USA. jepstein@uic.edu
Raber-Durlacher
Judith E
JE
Raber-Drulacher
Judith E
JE
Wilkins
Affi
A
Chavarria
Maria-Gabriella
MG
Myint
Han
H
D016026:Bone Marrow Transplantation; D017742:Dental Care for Chronically Ill; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D016867:Immunocompromised Host; D019520:Living Donors; D017710:Lymphocyte Transfusion; D052016:Mucositis / Q000209:etiology; D009369:Neoplasms / Q000628:therapy; D006472:Oral Hemorrhage / Q000209:etiology; D036102:Peripheral Blood Stem Cell Transplantation; D013280:Stomatitis / Q000209:etiology; D013651:Taste Disorders / Q000209:etiology; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014987:Xerostomia / Q000209:etiology