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Oral carcinoma after hematopoietic stem cell transplantation--a new classification based on a literature review over 30 years.

ABSTRACT: BACKGROUND: Patients undergoing hematopoietic stem cell transplantation (HSCT) have a higher risk of developing secondary solid tumors, in particular squamous cell carcinoma, because of several risk factors, including full-body irradiation (TBI), chemotherapy, and chronic graft versus host disease (GVHD). Based on the review presented here, a classification of oral changes is suggested in order to provide a tool to detect high-risk patients. METHODS AND RESULTS: The literature over the last 30 years was reviewed for development of malignoma of the oral cavity after HSCT. Overall, 64 cases were found. In 16 out of 30 cases, the tongue was the primary location, followed by the salivary gland (10 out of 30); 56.4% appeared in a latency time of 5 to 9 years after HSCT. In 76.6%, GVHD was noticed before the occurrence of oral malignancy. Premalignant changes of the oral mucosa were mucositis, xerostomia, and lichenoid changes, developing into erosive form. CONCLUSION: All physicians involved in the treatment of post-HSCT patients should be aware of the increased risk, even after 5 years from the development of oral malignancy, in particular when oral graft versus host changes are visible. In order to develop evidence based management, screening and offer adequate therapy as early as possible in this patient group, multicenter studies, involving oncologists and head and neck surgeons, should be established.

SUBMITTER: Kruse AL

PROVIDER: S-EPMC2724375 | biostudies-other | 2009

REPOSITORIES: biostudies-other

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Oral carcinoma after hematopoietic stem cell transplantation--a new classification based on a literature review over 30 years.

Kruse Astrid L D AL Grätz Klaus W KW

Head & neck oncology 20090722

<h4>Background</h4>Patients undergoing hematopoietic stem cell transplantation (HSCT) have a higher risk of developing secondary solid tumors, in particular squamous cell carcinoma, because of several risk factors, including full-body irradiation (TBI), chemotherapy, and chronic graft versus host disease (GVHD). Based on the review presented here, a classification of oral changes is suggested in order to provide a tool to detect high-risk patients.<h4>Methods and results</h4>The literature over ...[more]

PMID: 19624855

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Project description:Publication and authorship are important in academia for career advancement, obtaining grants, and improved patient care. There has been a recent interest in bibliometric changes over time, especially regarding the gender gap. The purpose of this study was to explore bibliometric changes in the musculoskeletal literature. Bibliometric variables (number of authors, institutions, countries, pages, references, corresponding author position, author gender, geographic region of origin, and editorial board makeup) were analyzed for 5 basic science and 12 clinically oriented musculoskeletal journals from 1985 through 2016. Statistical analyses comprised bivariate analyses, multifactorial ANOVAs, and logistic regression analyses. A p < 0.005 was considered significant. Nearly, all variables increased over time. Asia had the highest number of authors and corresponding author positions, Australia/New Zealand the highest number of institutions and references, North America the highest number of pages, and Europe the highest number of countries. Those with a female first author had more authors, institutions, countries, references, and pages. Likewise, those with a female corresponding author had more authors, institutions, countries, references, and pages. Single-authored manuscripts decreased over time. The percentage of female first authors rose from 10.8% in 1985-1987 to 23.7% in 2015-2016. There were more female 1st authors in the basic science journals compared to the clinical journals (33.2% vs. 12.7%). Single-authored manuscripts were more likely to be written by males (5.1 vs. 2.4%) and decreased over time. The many differences by geographic region of origin likely reflect different socio/cultural attitudes regarding academia and research, as well as the gender composition of the disciplines by geographic region. Overall, there has been an increase in the number of female 1st and corresponding authors, editorial board members, and chief editors, indicating a slow but progressive narrowing of the gender gap.

Project description:Hematopoietic stem cell transplantation (HSCT) has been an effective method for treating a wide range of malignant or non-malignant disorders. In case of an autologous HSCT, patients receive their own stem cells after myeloablation before extraction. Allogeneic HSCT uses stem cells derived from a donor. Despite being associated with a high risk of early and long-term complications, it is often the last curative option. 229 pediatric patients, who between 1 January 2005 and 31 December 2015 received an HSCT at the University Children's Hospital Wuerzburg, were studied. Correlations between two groups were calculated with the Chi square test or with a 2x2-contingency table. To calculate metric variables, the Mann-Whitney-U-test was used. Survival curves were calculated according to Kaplan and Meier. Significance was assumed for results with a p-value <0.05 (CI (Confident Interval) 95%). We retrospectively analyzed 229 pediatric patients (105 females, 124 males) for early and late complications of allogeneic and autologous hematopoietic stem cell transplantation. Median age at HSCT was seven years. Underlying diseases were leukemia (n = 73), lymphoma (n = 22), solid tumor (n = 65), CNS (central nervous system)- tumor (n = 41), and "other diseases" (n = 28). Survival times, overall survival, and event-free survival were calculated. Of all patients, 80.8% experienced complications of some degree, including mild and transient complications. Allo-HSCT (allogeneic HSCT) carried a significantly higher risk of complications than auto-HSCT (autologous HSCT) (n = 118 vs. n = 67; p = < .001) and the remission rate after allo-HSCT was also higher (58.7% vs. 44,7%; p = .032). Especially infection rates and pulmonary complications are different between auto- and allo-HSCT. Leukemia patients had the highest risk of early and late complications (95,0%; p < .001). Complications within HSCT are major risk factors following morbidity and mortality. In order to detect complications and risk factors early, strict recordings are needed to reduce the rate of complication by recognition and prevention of triggering factors. In the future, these factors should receive greater attention in the planning of HSCT post-transplantation care in order to improve the results of the transplantation and establish protocols to prevent their occurrence.

Project description:Veterinary dentistry and oral surgery are relatively new clinical disciplines that have rapidly evolved in the last few decades. Although clinical standards of care are supported by a growing body of literature, the extent to which peer-reviewed, evidence-based studies have contributed to advancing the practice of dentistry and oral surgery has not been assessed. The purpose of this study was to survey literature on the clinical practice of small animal dentistry and oral surgery published over the past 40 years to evaluate the levels of evidence over time, authorship affiliation, funding, and clinical subdisciplines within the field. A literature search was conducted in PubMed and the identified articles were screened for inclusion. A total of 1,083 articles were included for final analysis. Three reviewers independently assessed and assigned each article to one of nine predetermined study design categories. Systematic reviews and meta-analyses were considered the highest level of evidence, whereas expert opinion and experimental (ex vivo, in vitro, or in silico) studies were deemed the lowest levels of evidence. For statistical analysis and interpretation, study type was dichotomized into high evidence designs from which causal inference and/or associations could be derived, and low evidence designs which were purely descriptive or non-clinical experiments. No statistically significant difference in the distribution of study type was seen over time, with the majority of research in the last 5 years being largely at high risk of bias and descriptive in nature: 80.6% of articles published between 2014 and 2019 were assigned to the low evidence design tier. The type of study was found to differ by author affiliation: high evidence study designs were found more often than expected when author affiliation was multi-institutional or industrial, whereas private practice authorship was underrepresented in the high evidence design tier. To meet the increasing demand for evidence-based studies on the practice of dentistry and oral surgery in dogs and cats, researchers are encouraged to consider study design when testing hypotheses to improve the quality of research.

Dataset Information

Oral carcinoma after hematopoietic stem cell transplantation--a new classification based on a literature review over 30 years.

Publications

Oral carcinoma after hematopoietic stem cell transplantation--a new classification based on a literature review over 30 years.

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