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Doctoral Thesis
DOI
https://doi.org/10.11606/T.23.2009.tde-28092009-160518
Document
Author
Full name
Paulo Sergio da Silva Santos
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2009
Supervisor
Committee
Magalhães, Marina Helena Cury Gallottini de (President)
Dulley, Frederico Luiz
Liquidato, Bianca Maria
Rezende, Nathalie Pepe Medeiros de
Sousa, Suzana Cantanhede Orsini Machado de
Title in Portuguese
Avaliação clínica e histológica da doença do enxerto-contra-hospedeiro crônica de mucosa oral
Keywords in Portuguese
Manifestações bucais
Rejeição de enxerto
Transplante de Medula Óssea
Abstract in Portuguese
A Doença do Enxerto Contra Hospedeiro (GVHD) é a maior causa de morbidade e mortalidade em pacientes submetidos ao Transplante de Células-Tronco Hematopoiéticas (TCTH). As manifestações bucais podem ser debilitantes, levar a complicações sistêmicas e comprometer o prognóstico do paciente. O diagnóstico final deve ser estabelecido histologicamente. Recentemente o consenso estabelecido pelo NIH (National Institutes of Health) recomendou o uso de uma nova classificação histopatológica para o GVHD. No entanto a possível associação entre os quadros clínico e histopatológico de GVHD crônico (GVHDc), bem como a validação desta nova classificação ainda não estão claros na literatura. Desta forma, este estudo teve por objetivo validar a nova classificação, compará-la com outra já existente, correlacioná-la com o estágio clínico do GVHD e com a sobrevida dos pacientes transplantados. Para este estudo foram analisados biopsias de mucosa oral de 41 pacientes com diagnóstico clínico e histopatológico de GVHDc. Os aspectos histopatológicos foram observados pelo autor deste trabalho e pelo seu orientador, de forma cega, aplicando os critérios de Horn e do Consenso. A classificação do Consenso mostrou se válida, fácil de ser aplicada e apresentou correlação com a classificação de Horn. Não houve correlação da classificação histológica com o estágio clínico da doença e casos classificados histologicamente como mais graves estavam relacionados com menor sobrevida.
Title in English
Clinical and histological evaluation of the chronic graft-versus-host disease of the oral mucosa
Keywords in English
Bone Marrow Transplantation
Graft rejection
Oral manifestations
Abstract in English
The graft-versus Host Disease (GVHD) is the major cause of morbidity and mortality in patients undergoing Hematopoietic stem cell transplantation (HSCT). The oral manifestations can be debilitating, leading to systemic complications and compromise the patient's prognosis. The final diagnosis must be established histologically. Recently the consensus established by the NIH (National Institutes of Health) recommended the use of a new classification for histopathological chronic GVHD (cGVHD). However, the possible association between clinical and histopathology of cGVHD, as well as validation of this new classification is not yet clear in the literature. Thus, this study aimed to validate the new classification, compare it with the existing, correlating it with the clinical stage of GVHD and the survival of transplanted patients. For this study we analyzed biopsies from oral mucosa of 41 patients with clinical and histopathological diagnosis of cGVHD. The histopathological features were observed by the author of this work and his supervisor, in a blinded fashion, using the criteria of consensus and Horn. A classification of consensus shown is valid, easy to apply and also correlated with the classification of Horn. There was no correlation with histological classification of the clinical stage of disease and cases histologically classified as more severe were associated with lower survival.
 
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Publishing Date
2009-12-19
 
WARNING: The material described below relates to works resulting from this thesis or dissertation. The contents of these works are the author's responsibility.
  • FERNANDES, Karin, et al. Repercussão bucal da Doença do Enxerto Contra o Hospedeiro em pacientes submetidos ao TCTH. Pratica Hospitalar, 2011, vol. 77, p. 47-50.
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