Regenerative Medicine for Oral Mucositis

سال انتشار: 1397
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 344

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شناسه ملی سند علمی:

NSCMRMED03_085

تاریخ نمایه سازی: 30 دی 1397

چکیده مقاله:

Background and Aim: Oral mucositis represents a severe clinical issuefor all patients undergoing chemotherapy, and radiotherapy. Duringthe cytopenic phase, serious infections and organ toxicities can occur.Oral mucositis leads to a high risk of oral per-infections. Symptoms ofmucositis vary from pain and oesophagitis to complete interruption offood intake. Parenteral nutrition and opiates administration are oftenrequired. Recently, platelet gel (PG) has been shown to have a strongcapacity for tissue regeneration thanks to the release of growth factors.These promote the reepithelisation and angiogenesis through therecruitment of mesenchymal stem cells (MSCs).Methods: A 68-year-old woman was admitted in December 2015because of a mantle cell LNH. In September 2016, she underwentautologous hematopoietic stem cell transplantation (HSCT) with FEAM(fotemustine plus etoposide, cytarabine, and melphalan). Duringaplasia, she developed grade IV oropharyngeal mucositis, septic shockand cytomegalovirus infection. Cord blood blatelet gel (CBPG) wasadministered twice a day.Results: The patient was asked to place the CBPG in her mouth cavity andto distribute it with her tongue on the inside mucosa. After only 3 daysof consecutive application, a significant improvement in mucositis andpain was observed. On day 8, restituto ad integrum of her mucosa wasnoted. Furthermore, in association with the mucosal healing, the trendof lymphocytes showed a peak, which was not observed for the totalwhite cell count or for neutrophils. The patient’s general condition slowlyimproved. After 3 weeks, the patient was discharged from the hospital.Conclusion: Our findings are in keeping with previous studies on PG.The trend of lymphocytes showed a peak immediately after CBPGapplication, which might have helped to clear up the CMV infection.The positive outcome of our patient supports the need for controlledstudies on the efficacy of CBPG for the treatment of severe oral mucositisin patients who receive treatment with high-dose chemotherapy.

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نویسندگان

Andrea Piccin

University of Medicine, Innsbruck, Austria- Transfusion Service, Bolzano, Italy- Department of Pediatric Hematology, OLCH, Dublin, Ireland