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Osteonecrosis of the jaw secondary to haematopoietic stem cell transplantation
  1. Shaiba Sandhu1,2,3 and
  2. Vidya Sankar4
  1. 1Department of Oral Medicine, Harvard School of Dental Medicine, Boston, Massachusetts, USA
  2. 2Brigham and Women's Hospital, Boston, Massachusetts, USA
  3. 3Dana Farber Cancer Institute, Boston, Massachusetts, USA
  4. 4Tufts University School of Dental Medicine, Boston, Massachusetts, USA
  1. Correspondence to Dr Shaiba Sandhu; ssandhu{at}bwh.harvard.edu

Abstract

Osteonecrosis of the jaw (ONJ) is necrosis of mandibular or maxillary bone, which sometimes leads to bone exposure and sequestration. There is evidence that the microenvironment of the marrow stromal system is severely and irreversibly damaged after haematopoietic stem cell transplantation (HSCT) leading to a deficit in the quantity and quality of osteoblastic progenitors, compromising the ability to regenerate a normal osteogenic cell population and abnormality in bone remodelling/turnover. While osteonecrosis of the appendicular skeleton is a common complication after HSCT, there have been no reports of an association with ONJ. This is a report of the first case of ONJ secondary to HSCT in a 69-year-old woman who developed a unique pattern of osteonecrosis involving all four quadrants of the jaw 2 months after allogeneic stem cell transplantation.

  • dentistry and oral medicine
  • haematology (drugs and medicines)

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Footnotes

  • Contributors SS and VS: conception and design, and acquisition of the data; drafting the article or revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.