Fatores de risco para mucosite oral em pacientes submetidos ao transplante de células-tronco hematopoiéticas

Abstract

Aim: To evaluate the hematological, microbiological parameters, therapeutic scheme and Oral Mucositis (OM) incidence in patients submitted to Hematopoietic stem cell transplantation (HSCT). Material and Methods: This is an observational study in each blood samples were collected from 15 patients to perform Epstein Baar (EBV), Cytomegalovirus (CMV) and Herpes virus (HSV) serology, and hemogram. Dental and periodontal disease were too evaluated. After transplantation the patients were clinically evaluated for identification of oral mucosal changes, such as mucositis, opportunistic infections and pain assessment, on days D+3, D+6, D+9 and D+10. Friedman/Dunn, Fisher ’ s exact and X² tests were used for statistical evaluation (p<0.05, SPSS). Results: 93.3% of the patients had gone through at least one episode of OM, and level one was the most prevalent, 48,0% (n=36) and pain was higher in D+3 (p<0.001). Thirteen patients (86.7%) did not present reactive IgM to HSV and in none of them was identified IgM for EBV or CMV. 93.3% patients were IgG reagents for both EBV and CMV and three patients presented candidiasis. There was a significant increase in the number of patients with hematocrit<30.0% (p=0.005), platelets<50,000/mm3 (p=0.011), and leukocytes <2,000/mm3 (p=0.145). However, only patients with <2,000 leukocytes (p = 0.044) presented MO in D+10 (100%), being 15.9 more common in these patients. Conclusions: patients submitted to HSCT present a high incidence of OM episodes, but no association with fungal or viral infections. OM showed a strong relationship with leukopenia, with grade 1 being the most prevalent. It is suggested that hematological factors may be related and predict the onset of oral mucositis, impacting more effective prevention.