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Optimal Delivery of Follow-Up Care After Allogeneic Hematopoietic Stem-Cell Transplant: Improving Patient Outcomes with a Multidisciplinary Approach.

The increasing indications for allogeneic stem-cell transplant in patients with hematologic malignancies and non-malignant diseases combined with improved clinical outcomes have contributed to increase the number of long-term survivors. However, survivors are at increased risk of developing a unique set of complications and late effects, besides graft-versus-host disease and disease relapse. In this setting, the management capacity of a single health-care provider can easily be overwhelmed. Thus, to provide appropriate survivorship care, a multidisciplinary approach for the long-term follow-up

Periodontal inflamed surface area in oral cavity associated with febrile neutropenia in patients with hematologic malignancy undergoing chemotherapy.

Febrile neutropenia (FN) is an infectious complication that develops during chemotherapy. Although the oral cavity can be an important infection route, it is unknown whether the oral environment is associated with FN. The present study examined the relationship between the oral environment using periodontal inflamed surface area (PISA), a new periodontal disease parameter, and FN in hematologic cancer patients undergoing chemotherapy. In this retrospective cohort study, 157 patients were divided into FN onset during chemotherapy (n = 75) and the FN negative groups (n = 82). The associations of

Oral complications in hematopoietic stem cell recipients: the role of inflammation.

Hematopoietic stem cell transplantation (HSCT) is widely used as a potentially curative treatment for patients with various hematological malignancies, bone marrow failure syndromes, and congenital immune deficiencies. The prevalence of oral complications in both autologous and allogeneic HSCT recipients remains high, despite advances in transplant medicine and in supportive care. Frequently encountered oral complications include mucositis, infections, oral dryness, taste changes, and graft versus host disease in allogeneic HSCT. Oral complications are associated with substantial morbidity and

Navigating Stomatologic Complications Secondary to Antineoplastic Agents-A Comprehensive Review.

This review systematically examines the oral complications associated with conventional and novel anti-cancer therapies. It highlights that while molecularly targeted agents including monoclonal antibodies targeting the vascular endothelial growth factor and its receptor, the epidermal growth factor receptor, tyrosine kinase inhibitors, and immune checkpoint inhibitors tend to exhibit a lower overall toxicity profile compared to traditional cytotoxic chemotherapeutics, they are nonetheless linked to significant oral adverse events. These complications encompass inflammatory mucosal reactions k

Triclosan/copolymer containing toothpastes for oral health.

BACKGROUND: Periodontal disease and dental caries are highly prevalent oral diseases that can lead to pain and discomfort, oral hygiene and aesthetic problems, and eventually tooth loss, all of which can be costly to treat and are a burden to healthcare systems. Triclosan is an antibacterial agent with low toxicity, which, along with a copolymer for aiding retention, can be added to toothpastes to reduce plaque and gingivitis (inflammation of the gums). It is important that these additional ingredients do not interfere with the anticaries effect of the fluoride present in toothpastes, and that

The effect of drug holiday before tooth extraction on the development of medication-related osteonecrosis of the jaw in cancer patients receiving intravenous bisphosphonates.

OBJECTIVES: Drug holidays are suggested to reduce the formation of osteonecrosis in patients under intravenous (IV) bisphosphonates (BPs) therapy. The objectives of this study are to evaluate the incidence of medication-related osteonecrosis of the jaw (MRONJ) following tooth extraction in cancer patients using IV BP, and to assess the effect of drug holiday on the development of MRONJ. Patients and. METHODS: A manuel search of the patient folders of Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hacettepe University was undertaken to identify cancer patients who used IV

Efficacy and tolerability of medical ozone gas insufflations in patients with osteonecrosis of the jaw treated with bisphosphonates-Preliminary data: Medical ozone gas insufflation in treating ONJ lesions.

Osteonecrosis of the Jaw (ONJ) is an adverse event reported especially in patients receiving cancer treatments regimen, bisphosphonates (BPs), and denosumab. We performed an open-label, prospective study in patients treated with zoledronic acid who developed ONJ lesions >2.5 cm, and had no benefit after the treatment with the standard therapy, to evaluate the efficacy and tolerability of medical ozone (O3) treatment delivered as gas insufflations on each ONJ lesions. Twenty-four patients (mean age 62.5, range 41-80; 12 female) with bone metastases due to breast (11), prostate (4)and lung (4)ca

Oral care and the use of bone-targeted agents in patients with metastatic cancers: A practical guide for dental surgeons and oncologists.

BackgroundBone-targeted agents such as bisphosphonates and the RANKL antibody have revolutionised the care of patients with bone metastases. There has, however been increasing concern about the oral health of these patients and in particular osteonecrosis of the jaw (ONJ), especially with the increasing use of these agents at higher potencies for greater periods of time.MethodsA review of the published data in PubMed and meeting abstracts was performed to examine incidence, risk factors, pathogenesis, clinical course and management of osteonecrosis of the jaw with focus on cancer patients trea

Pathogenesis of Oral Toxicities Associated with Targeted Therapy and Immunotherapy.

Targeted therapy and immunotherapy have redefined cancer treatment. While they have enhanced tumor response and improved survival rates in many cancer types, toxicities continue to occur, and these often involve the oral cavity. Broadly reported as "mucositis" or "stomatitis," oral toxicities induced by targeted therapies differ clinically and mechanistically from those associated with conventional chemotherapy. Manifesting primarily as mucosal lesions, salivary gland hypofunction, or orofacial neuropathies, these oral toxicities may nonetheless lead to significant morbidity and impact patient

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… With the increased risk of dental sequelae (e.g., caries, recurrent candidiasis infections), regular dental examinations, including frequent dental prophylaxis and the prescription of topical fluoride treatments, is recommended. 2.6. …

Potential role of the comprehensive tooth extraction procedure in preventing medication related osteonecrosis of the jaw (MRONJ): a prospective cohort study.

BACKGROUND: This article aims to elucidate the potential role of a comprehensive tooth extraction procedure in preventing mdication-related osteonecrosis of the jaw (MRONJ) through a prospective cohort study. By systematically assessing clinical outcomes following this procedure, the study seeks to provide evidence regarding its effectiveness in MRONJ prevention, thereby contributing to improved clinical guidelines and patient care related to dental extractions in at-risk populations. METHODS: Patients using anti-resorptive agents (ARAs) who required extraction of at least one tooth were incl

CAR T-Cell Terrapy Opveiled: Навигация за пределы ССЗ и ИКАНС для решения проблем, связанных с отсроченными последствиями, и оптимизации стратегий управления.

Цимерическая антигенная рецепторная (КАР) T-клетологическая терапия положила начало эпохе преобразований в регулировании рецидивов/отсутствий гематологической гематологии. Кульминацией интенсивных испытаний второго этапа, направленных на борьбу с повторной/охотничьей лимфомой, включая различные подтипы, такие, как диффузная большая лимфома B-клеток, фолликулярная лимфома и лимфома мантичной клетки, а также многочисленные миелома и острая лимфоболическая лейкемия B-клеток, стало одобрение различных продуктов CAR-T-клеток для этих конкретных указаний Администрацией по вопросам продовольствия и н

Incidence of oral manifestations in hematological malignancy patients undergoing chemotherapy: prospective cohort study.

BackgroundOral manifestations are frequent in patients with hematological malignancies undergoing chemotherapy and may be directly or indirectly related to drug toxicity. Few studies have assessed the chemotherapy and oral manifestations that patients might develop. Therefore, this study aimed to evaluate the incidence of oral manifestations in patients with hematologic neoplasms during hospitalization and chemotherapy.Material and methodsA Prospective Cohort Study, in which adult patients diagnosed with hematological malignancies undergoing chemotherapy were followed up daily to observe the p

Timing of dental surgery in patients receiving bone-modifying agents: Medication related osteonecrosis of jaw (MRONJ) and implant outcomes in a cohort of 5,284 oncology patients within an integrated dental pathway.

BACKGROUND: Medication-related osteonecrosis of the jaws (MRONJ) is an important toxicity of bone-modifying agents (BMAs). Guidelines recommend dental assessment and risk reduction before high-dose antiresorptive therapy, but real-world data on outcomes by timing of dental procedures relative to BMA therapy remain limited [1-4]. This study evaluated MRONJ and implant outcomes according to the timing of dentoalveolar surgery within an integrated oncology-dental pathway. MATERIAL AND METHODS: We retrospectively reviewed 5,284 consecutive patients referred for dental evaluation in the context of

Oral Candida carriage and resistance against common antifungal agents in hematopoietic stem cell transplantation recipients.

PurposeAllogeneic hematopoietic stem cell transplant (HSCT) recipients receiving long-term and high-dose immunosuppressive medications suffer commonly from oral candida infections. This prospective cohort study examined oral fungal carriage in HSCT recipients and screened the susceptibility against commonly used antifungal agents. An increasing oral occurrence of Candida spp. and the development of resistance against clinically administered fluconazole were hypothesized.MethodsTwo hundred HSCT recipients were included and followed up for 2 years post-HSCT. Oral microbiological specimens were a

Knowledge and Awareness of Medication-Related Osteonecrosis of the Jaw Among Dental Practitioners in Mumbai: A Questionnaire-Based Survey.

INTRODUCTION: Osteonecrosis of the jaw resulting from the adverse effects of medical treatments is known as medication-related osteonecrosis of the jaws (MRONJ). The knowledge of dental professionals about this condition is crucial in addressing it on a regional and global scale. This study aims to assess the knowledge and awareness of MRONJ among dental practitioners in Mumbai. MATERIALS AND METHODS: This descriptive cross-sectional study utilized a web-based questionnaire comprising 21 questions distributed to dental professionals and postgraduate students at dental colleges, hospitals, and

An Approach for the Prevention, Diagnosis, and Treatment of Jaw Osteonecrosis: Report of a Case Associated with Zoledronic Acid.

BACKGROUND Osteonecrosis of the jaw is a condition manifesting as necrotic bone for 8 weeks or more, with no history of radiotherapy. It is linked to the use of antiresorptive drugs, such as bisphosphonates and denosumab. We discuss in this case report the importance of infection control during clinical procedures in patients taking antiresorptives. CASE REPORT Our case report describes a 52-year-old woman who had received zoledronic acid injections for 7 years, who presented with osteonecrosis of the jaw in the region of teeth 24, 25, and 26, with no local trauma. The report proceeds to descr

Oral manifestations and dental management in patients undergoing CAR-T cell therapy: a retrospective observational study.

Chimeric antigen receptor T-cell (CAR-T) therapy has emerged as a highly effective treatment for refractory and relapsed hematologic malignancies. Despite its clinical benefits, CAR-T therapy is associated with a unique toxicity profile, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and prolonged immunosuppression. Oral complications in this population remain underreported. This retrospective case series was aimed at describing oral manifestations and dental management in patients undergoing CAR-T therapy at a tertiary referral cente

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… Therefore, comprehensive dental evaluation should be performed before initiation of the lymphodepletion regimen, with emphasis on identifying and eliminating potential sources of infection, providing oral hygiene instruction, and performing dental prophylaxis. …

State of oral mucosa as an additional symptom in the course of primary amyloidosis and multiple myeloma disease.

Multiple myeloma (myeloma multiplex (MM)) is a malignant non-Hodgkin's lymphoma derived from B cell. Its essence is a malignant clone of plasma cells synthesizing growth of monoclonal immunoglobulin, which infiltrate the bone marrow, destroy the bone structure, and prevent the proper production of blood cells components. The paper presents a case of 62-year-old patient who developed symptoms in addition to neurological and haematological changes in the oral mucosa in the course of multiple myeloma. The treatment resulted in partial improvement. The authors wish to draw attention not only to no

Treatment of oral mucositis in hematologic patients undergoing autologous or allogeneic transplantation of peripheral blood stem cells: a prospective, randomized study with a mouthwash containing camelia sinensis leaf extract.

Oral mucositis is an important side effect of hematopoietic stem cell transplantation (HCST), mainly due to toxicity of conditioning regimens. It produces significant pain and morbidity. The present study reports a prospective, randomized, non-blinded study testing the efficacy of a new mouthwash, called Baxidil Onco(®) (Sanitas Farmaceutici Srl, Tortona, Italy) in 60 hematologic patients undergoing HCST (28 autologous, 32 allogeneic). Baxidil Onco(®), used three times a day from Day -1 to Day +30, in addition to standard prophylactic schedules, was administered to 14 patients undergoing autol

Prevention of medication related osteonecrosis of the jaw after dentoalveolar surgery: An institution's experience.

BACKGROUND: Dentoalveolar surgery is a predisposing factor for medication related osteonecrosis of the jaw (MRONJ). The aim of our study was to evaluate the described surgical procedures to prevent the development of MRONJ after dentoalveolar surgery in patients receiving bisphosphonates. MATERIAL AND METHODS: In this retrospective study, sixty-three dentoalveolar surgeries were performed on 44 patients taking bisphosphonate in accordance with the treatment procedures we described. The following procedures were applied to patients 1) use of antibiotics 2) performed dentoalveolar surgical proc