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Head & Neck Oncology
Published in: Head & Neck Oncology 1/2009

Open Access 01-12-2009 | Review

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

Authors: Astrid LD Kruse, Klaus W Grätz

Published in: Head & Neck Oncology | Issue 1/2009

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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.
Appendix
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Metadata
Title
Oral carcinoma after hematopoietic stem cell transplantation – a new classification based on a literature review over 30 years
Authors
Astrid LD Kruse
Klaus W Grätz
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Head & Neck Oncology / Issue 1/2009
Electronic ISSN: 1758-3284
DOI
https://doi.org/10.1186/1758-3284-1-29

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