Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.1.1.69 (BMT)
 2,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

BMT results in multiple toxicities and organ dysfunction, which significantly influence the nutritional status of patients. The preparative regimen, which includes high-dose chemotherapy (with or without radiotherapy), causes nausea, vomiting, diarrhea, mucositis, anorexia, dysgeusia, and xerostomia. Conditioning may also contribute to infection and organ dysfunction. TPN is used as the principal method of nutritional support during the first month after transplantation. Oral feedings are primarily employed thereafter. A team approach is required to manage the nutritional aspects of care effectively in this complex patient population.
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PMID:Nutritional support of the bone marrow transplant patient. 249 49

Xerostomia due to chronic graft-versus-host disease (GVHD) or total-body irradiation (TBI) is an important cause of morbidity after BMT. The ophthalmic or oral form of pilocarpine, a parasympathomimetic agent with predominantly muscarinic activity, was given orally to 13 patients with moderate (n = 6) or severe (n = 7) xerostomia due to chronic GVHD (n = 7) or TBI (n = 6). The duration of 19 courses of therapy was 7-245 days (median 73). Ten patients (77%) noticed significant improvement in salivation and relief of symptoms which reached its maximum after 7-186 days (median 46). Difficulty in eating and speaking reduced, and there was a beneficial effect on the oral mucosa and teeth. Xerophthalmia improved in one of six patients. Five patients had adverse reactions: wheezing (n = 1), and increased sweating without (n = 3) or with (n = 1) abdominal cramps (n = 1): leading to discontinuation of pilocarpine in one. Three patients stopped pilocarpine, became symptomatic again, but the benefits were reproducible on restarting pilocarpine. The ophthalmic preparation was as effective as the oral, and was one-tenth the cost of the oral. We conclude that oral pilocarpine is effective in relieving xerostomia associated with chronic GVHD and TBI. The time taken for a response to be seen is variable, and unless significant adverse effects are encountered, pilocarpine should be continued for 6-8 weeks before it is considered to have failed.
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PMID:Pilocarpine hydrochloride for symptomatic relief of xerostomia due to chronic graft-versus-host disease or total-body irradiation after bone-marrow transplantation for hematologic malignancies. 908 44

Bone marrow transplantation is considered to be the treatment of choice for various hematological and solid malignancies, as well as for bone marrow failure syndromes and some genetic diseases. Unfortunately, a great number of patients who receive allogeneic BMT suffer from graft-versus-host disease (GVHD) following the procedure. Xerostomia is considered to be one of the most annoying complications of chronic GVHD (cGVHD), and the rapidly growing number of BMT patients with prolonged survival renders GVHD-related xerostomia a major clinical problem. As pilocarpine hydrochloride has been shown to relieve xerostomia in other disease categories, we administered pilocarpine hydrochloride 30 mg/day to six cGVHD patients and measured their whole saliva, parotid and submandibular-sublingual flow rates in both resting and stimulated conditions. Mean values of flow rates of whole saliva in resting conditions at 2 weeks, 2 months and 6 months following administration of pilocarpine hydrochloride 30 mg/day were 0.71 +/- 0.12 ml/min, 0.59 +/- 0.07 ml/min and 0.56 +/- 0.11 ml/min, respectively. In stimulated conditions, mean values were 1.7 +/- 0.3 ml/min, 1.0 +/- 0.17 ml/min and 0.94 +/- 0.21 ml/min, respectively. The mean values of whole saliva flow rates under both conditions represented an increase of 224-284% and 134-247%, respectively (P < 0.01). The pattern and magnitude of parotid and submandibular-sublingual flow rate increases following pilocarpine hydrochloride administration were similar. Patients were followed for 6 months and demonstrated increased levels of secretion, with some reduction after the initial peak values. The medication was discontinued at 2 months and reinstated after 2 weeks in three patients. This resulted in rapid flow rate reduction followed by another profound increase. Contrary to the sialometrical analysis, the subjective scoring showed no fluctuations during the study period. We discuss these results in the context of the clinical experience of xerostomic patients in whom even a minute increase in secretion may be significant. Our results demonstrate that objective and subjective relief from xerostomia in cGVHD patients can be achieved with the routine oral administration of pilocarpine hydrochloride.
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PMID:Pilocarpine hydrochloride relieves xerostomia in chronic graft-versus-host disease: a sialometrical study. 1037 66

This is the first Swedish study to evaluate the health-related quality of life and sense of coherence in adult survivors of allogeneic, haematopoietic stem cell transplantation (HSCT). Twenty-five recipients completed three questionnaires 2-4 years after the transplantation. The questionnaires used were the Sickness Impact Profile (SIP), the Symptom Frequency Intensity and Distress (SFID-BMT) scale and the Sense of Coherence (SOC) scale measuring subjective functional status, symptom distress and coping ability. Impairments in functional status were found, as compared with a population norm. The most common impairments were found in the areas of social interaction and sleep and rest. Eye problems, dry mouth, cough, sexual problems, tiredness, anxiety and changes of taste were symptoms reported by more than half of the patients. Despite impaired functioning and a high incidence of symptoms, the general health was described as quite good or excellent by 80% (n = 20) of the patients. The majority (20/22) had also been able to return to work or to attend school. No difference in the sense of coherence was seen, as compared with the population norm. Functional impairments were significantly correlated to a lower degree of sense of coherence.
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PMID:Health-related quality of life, symptom distress and sense of coherence in adult survivors of allogeneic stem-cell transplantation. 1182 45