Změny na sliznicích dutiny ústní u hematoonkologických pacientů

Title in English Changes of oral membrane mucous at haematooncology patients
Authors

POSKEROVÁ Hana AUGUSTÍN Peter TOMÍŠKA Miroslav FASSMANN Antonín

Year of publication 2010
MU Faculty or unit

Faculty of Medicine

Citation
Description A number of patients with haematooncology diseases is currantly increasing. These patients are more and more treated by the most modern therapeutic methods. These people have a lot of problems due to their basic haematooncology diseases. They also suffer from the associated symptoms and unpleasant side effects of the therapy. All these symptoms can express themselves on oral membrane mucous. First group of problems is directly connected with basic haematooncology disease. In the case leukemias disturbances of the bone marrow results into trombocytopenia and following bleeding of oral membrane mucous and of gingiva. Infiltration of gingiva of immature leukemic cells can cause hyperplastic overgrowths of gingiva. Painful ulceration appears on gingival overgrowths and on other places of oral cavity. Second group of changes in oral cavity is caused by side effects of oncology treatment. Mucositis rise as a consequence of chemotherapy or radiotherapy and the degree of injury of mucosal tissue is directly related to the type of treatment. In case of higher dosed regimens of chemotherapy in preparation for haematopoietic cell transplantation mucosistis appears at most of patients. There are manifested as erythema, oedema, atrophy and ulcerative lesions of the mouth. This painful involvement deteriorate eating, talking, swallowing, maintenance of oral hygiene and there is also higher risk of infectious complications. Patients who were treated by haematopoietic cell transplantation may suffer from a graft versus host disease. This is serious complication and it is caused by an immunologic reaction of the transplanted cells, above all by lymphocytes, against the receiving organism. It expresses itself in oral cavity as reaction which appears as an oral lichen planus. Third group of problems that we can find in oral cavity at haematooncology patients are concomitant bacterial, viral and fungal infections. Basic oncology disease, chemotherapy, radiotherapy and immunosuppressive treatment dramatically reduce immunity of an organism. These patients are increasingly susceptible to opportunistic infection. Taking into account seriousness of haematooncology a comprehensive access and interdisciplinary cooperation within treatment of these patients are very important. A dentist specialized on oral membrane mucous should become a member of the medical team taking care of these patients. He can contribute to improvement of their oral health and living comfort.

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