Bone marrow transplantation (BMT) has been used to treat numerous malignant and non-malignant hematological diseases, genetic and immunological diseases with a high risk of oral mucositis (OM) due to the action of antineoplastic drugs. As photobiomodulation therapy (FBMT) with low-level laser is a proven non-invasive treatment for OM, the objective of this study was to evaluate the incidence of OM in patients on BMT undergoing FBM. 53 patients undergoing treatment received FBMT (red laser, 2J, 20s, 100mW) as a preventive protocol. If MO was observed, an infrared laser (4J, 40s, 100W) was administered. The following data were collected from patients' medical records: sex, age, chemotherapy protocol (QT) and type of BMT. An incidence of 34% was observed in the population studied (20% grade I, 11.3% grade II and 1.9% grade III). Prevention protocols using FBMT significantly reduced the incidence of oral mucositis (p = 0.004). Now, young patients with myeloid leukemia, the time between QT and BMT (p = 0.010) and time of QT (p = 0.018) were directly associated with the increased incidence of oral mucositis. It was concluded that low-intensity preventive laser therapy was associated with a reduction in the incidence of oral mucositis, showing the importance of this therapy in the management of patients undergoing BMT.
Objetivo: Avaliar os parâmetros hematológicos, microbiológicos, esquema terapêutico e incidência de Mucosite Oral (MO) em pacientes submetidos ao transplante de células-tronco hematopoéticas (TCTH). Material e Métodos: Trata-se de um estudo observacional em que foram coletadas amostras de 15 pacientes para realização de sorologia para Epstein Baar (EBV), Citomegalovírus (CMV) e Herpes vírus (HSV) e hemograma. Após o transplante os pacientes foram avaliados para identificação de alterações da mucosa oral, como mucosite, infecções oportunistas e avaliação da dor, nos dias D+3, D+6, D+9 e D+10. Os testes de Friedman/Dunn, exato de Fisher e X² foram usados para avaliação estatística (p<0,05, SPSS). Resultados: 93,3% dos pacientes haviam passado por pelo menos um episódio de MO, sendo o grau 1 o mais prevalente (48,0%, n=36) (p<0,001). Treze pacientes (86,7%) não apresentaram IgM reativa para HSV e em nenhum deles foi identificada IgM para EBV ou CMV. 93,3% dos pacientes eram IgG reagentes para EBV e CMV e três pacientes apresentavam candidíase. Houve aumento significativo de mucosite em pacientes com hematócrito<30,0% (p=0,005), plaquetas<50.000/mm3 (p=0,011) e leucócitos <2.000/mm3 (p=0,145). No entanto, apenas pacientes com <2.000 leucócitos (p = 0,044) apresentaram MO em D+10 (100%), sendo 15,9 mais comuns nesses pacientes. Conclusão: os pacientes submetidos ao TCTH apresentam alta incidência de episódios de MO, mas sem associação com infecções fúngicas ou virais. A MO apresentou forte relação com leucopenia, sendo o grau 1 mais prevalente. Sugere-se que fatores hematológicos possam estar relacionados e
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