Publications by authors named "Alexa M G A Laheij"

Article Synopsis
  • The study aimed to assess how myelosuppressive chemotherapy affects the oral microbiome and its correlation with oral mucositis (OM) and febrile neutropenia (FN) in cancer patients.
  • Researchers conducted a longitudinal analysis involving 46 patients, collecting oral rinsing samples at various stages of treatment, which were analyzed for changes in microbial diversity.
  • Significant alterations in the oral microbiome were found during chemotherapy and in the presence of OM, indicating a potential link between treatment and oral health complications, though more extensive studies are needed for confirmation.
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Article Synopsis
  • Oral chronic graft-versus-host disease (cGVHD) can lead to various symptoms affecting the mouth, contributing to a lower quality of life for patients.
  • Symptoms can include changes in the oral mucosa, reduced saliva production, and issues with surrounding soft tissues.
  • The review aims to offer a straightforward guide for diagnosing and managing oral health problems in both pediatric and adult patients who have received allogeneic hematopoietic cell transplantation (alloHCT) within the first two years after their procedure.
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Purpose: This review aimed to evaluate the prevalence and characteristics of dysgeusia after hematopoietic cell transplantation (HCT).

Methods: A literature search (in PubMed, Embase.com and Web of Science) for clinical studies evaluating taste before and after HCT was performed up to June 22, 2023, in collaboration with a medical information specialist.

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Article Synopsis
  • The study aimed to evaluate the salivary flow rates, perceived oral dryness, and dental caries in patients five years after undergoing hematopoietic cell transplantation (HCT).
  • A total of 39 survivors participated, with results showing a mean unstimulated saliva flow rate of 0.36 mL/min and a stimulated flow rate of 1.02 mL/min, while 73% reported experiencing some level of oral dryness.
  • The findings indicated that there was a slight increase in dental treatments needed post-HCT, with survivors undergoing an average of three treatments over five years following the transplant, although these changes were non-significant when compared to pre-transplant metrics.
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Purpose: To assess the self-reported oral health and oral health-related quality of life of patients diagnosed with hemato-oncological disease.

Patients And Methods: Data was collected through a digital questionnaire in collaboration with the Dutch patient organization Hematon. The questionnaires EORTC-QLQ-C30, EORTC-QLQ-OH15, shortened Xerostomia Inventory (XI), and the OHIP-14 were used.

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Advances in the treatment of cancer have significantly improved mortality rates; however, this has come at a cost, with many treatments still limited by their toxic side effects. Mucositis in both the mouth and gastrointestinal tract is common following many anti-cancer agents, manifesting as ulcerative lesions and associated symptoms throughout the alimentary tract. The pathogenesis of mucositis was first defined in 2004 by Sonis, and almost 20 years on, the model continues to be updated reflecting ongoing research initiatives and more sophisticated analytical techniques.

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With diagnostic and therapeutic advances, over 80% of children diagnosed with cancer become long-term survivors. As the number of childhood cancer survivors (CCS) continues to increase, dental practitioners become more likely to have CCS among their patients. CCS may develop late complications from damage caused by their cancer treatment to endocrine, cardiovascular, musculoskeletal, and other organ systems.

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Xerostomia, or subjective oral dryness, is a serious complaint after hematopoietic cell transplantation (HCT). Xerostomia is rated as one of the most bothersome symptoms by HCT recipients, negatively affecting quality of life. This substudy of the Orastem study, a prospective longitudinal, international, observational, multicenter study, aimed to describe the prevalence and severity of xerostomia following HCT.

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Objectives: Haematopoietic cell transplantation (HCT) preceded by a conditioning regimen is an established treatment option for (non)malignant haematologic disorders. We aim to describe the development of hyposalivation over time in HCT recipients, and determine risk indicators.

Materials And Methods: A multi-centre prospective longitudinal observational study was conducted.

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Background: The oral cavity is a potential source of infectious complications in patients treated with myelosuppressive chemotherapy (CT). Pre-chemotherapy oral examination to identify foci of infection is recommended, but it is unclear whether this should include panoramic radiography. The present study aimed to evaluate the additional diagnostic merit of panoramic radiography as part of pre-CT oral screening.

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Despite advances in transplant medicine, prevalence of complications after hematopoietic stem cell transplantation (HSCT) remains high. The impact of pre-HSCT oral health factors on the incidence and severity of complications post-HSCT is poorly understood. The aim of this prospective, observational study was to analyze oral health in patients planned for HSCT.

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Article Synopsis
  • - Oral mucositis (OM) is a significant side effect of cancer therapy, affecting up to 80% of patients, and is characterized by the destruction of epithelial cells and increased inflammation, creating a favorable environment for infections.
  • - Research is examining how changes in the oral microbiome may be linked to the development and severity of OM, beyond just opportunistic infections, through 16S rRNA gene sequencing in cancer patients.
  • - The review emphasizes the potential for targeting the microbiome as a therapeutic strategy in managing OM and discusses whether microbiome changes are causes or effects of mucosal damage.
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Background: A common complication of allogeneic hematopoietic stem cell transplantation (alloHSCT) is chronic oral graft vs. host disease (cGvHD). Oral cGvHD may present as mucosal lesions, salivary gland dysfunction, and trismus.

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Introduction: Febrile neutropenia (FN) is a potential life-threatening complication of myelosuppressive chemotherapy, particularly when induced by infection. There is evidence that FN can originate from the oral cavity, but its contribution to FN is largely understudied in patients treated for solid tumors. The aim of this study was to assess the prevalence of FN in these patients and to evaluate its relation with dental foci and oral mucositis.

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Haematopoietic stem cell transplantation (HSCT) preceded by a conditioning regimen is an established treatment option for many haematological diseases. Decreased salivary flow rates after HSCT may increase caries risk. We aim to estimate the extent to which caries lesions develop or progress in adult HSCT recipients and assess its association with salivary flow rates.

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Stem cell transplantation (SCT) is associated with oral microbial dysbiosis. However, long-term longitudinal data are lacking. Therefore, this study aimed to longitudinally assess the oral microbiome in SCT patients and to determine if changes are associated with oral mucositis and oral chronic graft-versus-host disease.

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Dental practices were approached to fill out a questionnaire on the infection control protocols in use to control biofilm growth in the dental unit and to send two types of water sample. Sampling of the dental units had to be performed prior to any infection control measures and on the second day of operation, to avoid residual effects of biofilm disinfection protocols performed in the weekend. Instructions were given on how to sample the units.

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Dental unit water systems are prone to biofilm formation. During use of the dental unit, clumps of biofilm slough off and can subsequently be aerosolized and inhaled by both patient and staff, potentially causing infections. The aim of this study was to determine the microbial load and microbiome of dental unit water, in the Netherlands, and the factors influencing these parameters.

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Article Synopsis
  • This study examined how oral chronic graft-versus-host disease (cGVHD) impacts the oral health-related quality of life (OHRQoL) in patients, highlighting the symptoms' significant effects.
  • It involved 56 patients, where it was found that 80% had varying severities of oral mucosal cGVHD, with patients reporting issues like oral sensitivity and dryness.
  • The research concluded that oral pain and sensitivity were key factors negatively affecting OHRQoL, indicating the need for heightened attention from healthcare professionals to support cGVHD patients better.
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Background: Biofilm formation in dental unit waterlines (DUWL) may lead to health risks for dental staff and patients. Therefore, dental unit waterlines need to be disinfected, for instance by using chemical disinfectants. However, the application of chemical disinfectants may lead to the selection of specific microorganisms.

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Purpose: Clinical and in vitro studies showed selected oral microorganisms to be related to delayed wound healing and ulcerative oral mucositis. However, it is not known whether this effect is due to reduced metabolism and/or the reduced reproductive capacity of epithelial cells. Therefore, we studied the influence of the oral microorganisms Porphyromonas gingivalis, Candida glabrata, and Candida kefyr on cell metabolism and reproductive capacity of oral epithelial cells, aimed to further unravel the pathogenesis of oral mucositis.

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The aim of this prospective, two center study was to investigate the dynamics of the microbial changes in relation to the development of ulcerative oral mucositis in autologous SCT (autoSCT) recipients. Fifty-one patients were diagnosed with multiple myeloma and treated with high-dose melphalan followed by autoSCT. They were evaluated before, three times weekly during hospitalization, and three months after autoSCT.

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Febrile neutropenia (FN) is an inflammatory response causing fever that may develop during cancer therapy-induced neutropenia. FN may herald life-threatening infectious complications and should therefore be considered a medical emergency. Patients presenting with FN are routinely subjected to careful history taking and physical examination including X-rays and microbiological evaluations.

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Microorganisms play a role in oral mucositis after cancer therapy. The current study explored the hypothesis that spp. alone and together with Porphyromonas gingivalis cause delayed healing of oral ulcerations due to the inhibition of wound closure.

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Background: Radiotherapy to the head and neck area damages the salivary glands. As a consequence hyposalivation may occur, but also the protein composition of saliva may be affected possibly compromising oral health. The aim of our study was to compare the relative abundance of proteins and peptides in parotid saliva of irradiated patients to that of healthy controls.

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