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Significant oral graft-versus-host disease after allogeneic stem cell transplantation with the FLU/MEL conditioning regimen
S. Vokurka, T. Svoboda, M. Karas, V. Koza, P. Jindra, D. Kazakov, L. Boudova,
Jazyk angličtina Země Polsko
Typ dokumentu časopisecké články
NLK
PubMed Central
od 2011
Europe PubMed Central
od 2011
Open Access Digital Library
od 2011-01-01
PubMed
21873943
DOI
10.12659/msm.881933
Knihovny.cz E-zdroje
- MeSH
- akutní nemoc MeSH
- chronická nemoc MeSH
- dospělí MeSH
- homologní transplantace MeSH
- lidé středního věku MeSH
- lidé MeSH
- melfalan terapeutické užití MeSH
- mladý dospělý MeSH
- nemoc štěpu proti hostiteli etiologie patologie MeSH
- nemoci úst etiologie patologie MeSH
- příprava pacienta k transplantaci škodlivé účinky MeSH
- senioři MeSH
- transplantace kmenových buněk škodlivé účinky MeSH
- vidarabin analogy a deriváty terapeutické užití MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Oral graft-versus-host disease (GVHD) is a significant complication after allogeneic stem cell transplantation (SCT) and there is no consistent information about its characteristics in patients after reduced-intensity conditioning regimen FLU/MEL (fludarabine 120 mg/m² and melphalan 140 mg/m²). MATERIAL/METHODS: This was a single-centre prospective observational study of patients after allogeneic SCT with FLU/MEL conditioning performed during the period 1/2005-12/2007. Characteristics of oral GVHD were observed in 71 patients. The observation was discontinued due to death, donor lymphocyte infusion (DLI) or new chemotherapy administration. RESULTS: In 10/2010, the median duration of the observation of the cohort of the patients was 13 (0.2-69) months, and 42 (35-69) months in the still-ongoing 20/71 (28%) patients. Oral acute GVHD had sporadic 7% incidence, whereas oral chronic GVHD was observed in 33% of patients and persisted with median duration of 188 (11-665) days. Clinical and histopathological features were similar in both acute and chronic oral GVHD and included mucosal lichenoid changes, erythema, ulcerations and pseudomembranes, satellite necrosis, apoptotic bodies and lichenoid interface inflammation. CONCLUSIONS: It is necessary to consider complex clinical symptomatology and pathological correlations when classifying the oral GVHD, because local oral symptoms and histopathological features in both acute and chronic oral GVHD forms can be similar. Even though the oral chronic GVHD was mild in the majority of patients, it can be considered as clinically significant due to its incidence, duration and symptomatology. The FLU/MEL conditioning regimen should not be considered as low-risk protocol in this context.
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- $a Vokurka, Samuel $u Department of Hemato-Oncology, University Hospital in Plzen, Pilsen, Czech Republic. vokurka@fnplzen.cz
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- $a Significant oral graft-versus-host disease after allogeneic stem cell transplantation with the FLU/MEL conditioning regimen / $c S. Vokurka, T. Svoboda, M. Karas, V. Koza, P. Jindra, D. Kazakov, L. Boudova,
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- $a BACKGROUND: Oral graft-versus-host disease (GVHD) is a significant complication after allogeneic stem cell transplantation (SCT) and there is no consistent information about its characteristics in patients after reduced-intensity conditioning regimen FLU/MEL (fludarabine 120 mg/m² and melphalan 140 mg/m²). MATERIAL/METHODS: This was a single-centre prospective observational study of patients after allogeneic SCT with FLU/MEL conditioning performed during the period 1/2005-12/2007. Characteristics of oral GVHD were observed in 71 patients. The observation was discontinued due to death, donor lymphocyte infusion (DLI) or new chemotherapy administration. RESULTS: In 10/2010, the median duration of the observation of the cohort of the patients was 13 (0.2-69) months, and 42 (35-69) months in the still-ongoing 20/71 (28%) patients. Oral acute GVHD had sporadic 7% incidence, whereas oral chronic GVHD was observed in 33% of patients and persisted with median duration of 188 (11-665) days. Clinical and histopathological features were similar in both acute and chronic oral GVHD and included mucosal lichenoid changes, erythema, ulcerations and pseudomembranes, satellite necrosis, apoptotic bodies and lichenoid interface inflammation. CONCLUSIONS: It is necessary to consider complex clinical symptomatology and pathological correlations when classifying the oral GVHD, because local oral symptoms and histopathological features in both acute and chronic oral GVHD forms can be similar. Even though the oral chronic GVHD was mild in the majority of patients, it can be considered as clinically significant due to its incidence, duration and symptomatology. The FLU/MEL conditioning regimen should not be considered as low-risk protocol in this context.
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