Oral mucositis after bone marrow transplantation. A marker of treatment toxicity and predictor of hepatic veno-occlusive disease

John R. Wingard, Carol S. Niehaus, Douglas E. Peterson, Richard J. Jones, Steven Piantadosi, L. Stefan Levin, Rein Saral, George W. Santos

Research output: Contribution to journalArticlepeer-review

Abstract

Oral mucositis and hepatic veno-occlusive disease (HVOD) are common complications after bone marrow transplantation (BMT). Forty-seven patients were prospectively examined for development of ulcerative oral mucositis (UOM) and HVOD after allogeneic BMT. In 17 patients (36%) UOM developed between 2 days before and 18 days after transplant (median 4 days after BMT). In seven patients (15%) HVOD developed with onset between 3 and 21 days after transplant (median 18 days after BMT). In a time-dependent analysis, in patients given busulfan plus cyclophosphamide or busulfan, etoposide, and cyclophosphamide UOM was 19 times more likely to develop than in patients treated by cyclophosphamide plus total body irradiation or by cyclophosphamide alone (p < 0.001). Patients in whom UOM developed were 6.5 times more likely to develop HVOD than those in whom UOM did not develop (p < 0.03). The sensitivity (86%), specificity (73%), and negative predictive value (97%) of UOM to predict HVOD were high, but the positive predictive value (35%) was low. The association of UOM and HVOD support the concept that both are toxic effects of treatment. Patients with hepatic abnormalities but without UOM are unlikely to have HVOD, and other causes of the hepatic dysfunction should be investigated.

Original languageEnglish (US)
Pages (from-to)419-424
Number of pages6
JournalOral Surgery, Oral Medicine, Oral Pathology
Volume72
Issue number4
DOIs
StatePublished - Oct 1991

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dentistry(all)

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