Simple analysis of a bone marrow transplant patient's oral rinse can give medical personnel a quick indication of the transplant's effectiveness and predict whether an infection will develop, says a University of Toronto researcher. Dr. Michael Glogauer, a U of T dentistry professor with the CIHR Group in Matrix Dynamics, Dr. Yigal Dror, a professor at the U of T Faculty of Medicine and a hematologist at the Hospital for Sick Children, and dentistry doctoral candidate Chrissy Cheretakis conducted the study, which received advance online publication this month in Bone Marrow Transplantation. "This test is telling you something you can't yet see in a blood test," says Glogauer, "and we obtained the information simply by having patients rinse their mouths, which is something they'd be doing anyway to counteract the oral mucositis caused by their treatment regimen."
The researchers monitored the oral rinses of 29 pediatric bone marrow transplant patients, testing the basic sodium bicarbonate solutions for the return of neutrophils, specialized white blood cells which fight infection. Their test was able to detect the white blood cells about a week earlier than the blood test which is commonly used to confirm a successful bone marrow transplant.
The gap between the time their test showed the presence of white blood cells in the mouth and the time the cells appeared in a blood test also indicated those patients who would likely be prone to infection during their recovery. A difference of less than four days was an excellent indicator of patients who were susceptible to infection, Glogauer says.
"It shows promise as a non-invasive way to track a patient's recovery," he says. "We are using mice to study the underlying mechanisms at work here to help us better understand white blood cell recovery and function during bone marrow transplant therapy."
"Dr. Glogauer's work is an excellent example of the way in which research is unravelling the complex relationship between oral health and systemic conditions," says Dr. Cy Frank, Scientific Director of CIHR's Institute of Musculoskeletal Health and Arthritis. "We applaud Dr. Glogauer and his colleagues for the creation of new knowledge that will greatly benefit patients requiring bone marrow transplants."
The researchers are now experimenting with ways to make the test applicable at the bedside by developing a reaction that will cause the rinse to turn colour when the presence of white blood cells is detected.
Dr. Glogauer is a CIHR clinician scientist and the study was funded by the Hospital for Sick Children Foundation.
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