骨髄移植後の慢性 Graft-versus-host-disease (GVHD) の口腔内症状

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Recently, a treatment with the allogenic bone marrow transplantation for leukemia and severe aplastic anemia has been attempted and a complete remission of these disease expected. A bone marrow transplantation is a treatment where a patient with bone marrow dysfunction undergoes a transplant of allogenic normal bone marrow. This transplanted bone marrow is expected as function as normal bone marrow. After a bone marrow transplantation, a graft-versus-host-disease (GVHD) may develop because of an immunoreaction. Chronic GVHD may develop about 100 days after a bone marrow transplantation. Key findings of chronic GVHD are erythema, reticular pigmentation, scleroderma, liver dysfunction, oral mucosa' symptom and Sicca syndrome. Oral symptoms of chronic GVHD arc (1) lichenoid keratosis of buccal mucosa, gingiva, tongue and lingual mucosa, and, (2) minor sialadenitis.<BR>Out of the 27 patients who underwent bone marrow transplants from November 1981 to March 1984 by the bone marrow transplantation group of the Japanese Red Cross Nagoya First Hospital eight patients who were suspected of chronic GVHD clinically were biopsied of the 8, five patients were histologically diagnosed as chronic GVHD. Six cases had minor salivary glands were detected, and for cases were diagnosed as sialadenitis.