Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
Oral medicineUse of sidestream dark-field (SDF) imaging for assessing the effects of high-dose melphalan and autologous stem cell transplantation on oral mucosal microcirculation in myeloma patients
Section snippets
Patient selection
The protocol for this investigation was reviewed and approved by the Medical Ethical Committee of the Academic Medical Center of the University of Amsterdam. Consecutive newly diagnosed patients (n = 10), 3 women and 7 men, with multiple myeloma (MM) undergoing first-time CT treatment with high-dose melphalan (200 mg/m2) and ASCT, mean age 54.5 ± 7.5 years (range 43-64 years) participated in this study. This was a single-center study in which all of the patients resided in the medical center
Results
The seated vertical inclination of the patients in their beds was favorable for bedside SDF imaging and allowed the possibility of stable image acquisitions and repeated measurements in all subjects while enduring posttreatment complications regarding nausea and emesis provoked by the high-dose CT. Two female patients withdrew from the study on day 8 and day 14 as a result of severe nausea with gag reflexes associated with cancer therapy. In all 10 patients the buccal mucosa was easily
Discussion
The aim of this study was to evaluate oral mucosal perfusion by monitoring and quantifying capillary density before and after high-dose CT and ASCT in MM patients. The results show that functional capillary density decreased progressively after treatment and was significantly compromised on days 6 and 8. Furthermore, the results indicate that SDF imaging successfully enabled temporal monitoring capabilities of the effects of CT on changes in capillary density and submucosal microvascular
Acknowledgements
The authors acknowledge and thank all of the patients for participating in this investigation. They thank Darryl Milstein from Skylab Industry for the illustration in Fig. 1, a.
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Supported by a 2006 research grant from the Foundation for the Promotion of Scientific Education and Scientific Activities (BOOA).
Can Ince is Chief Scientific Officer of MicroVision Medical, an AMC spin-off company dedicated to the development of optical spectroscopic devices for clinical use.