{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:40:10Z","timestamp":1791297610930,"version":"4.1.0"},"reference-count":20,"publisher":"BMJ","issue":"6988","license":[{"start":{"date-parts":[[1995,5,6]],"date-time":"1995-05-06T00:00:00Z","timestamp":799718400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[1995,3,21]]},"published-print":{"date-parts":[[1995,5,6]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:bold>\n : To evaluate (a) the prophylactic effect of the antiherpetic drug acyclovir on oral ulcers in patients with acute myeloid leukaemia receiving remission induction chemotherapy and thus (b), indirectly, the role of herpes simplex virus in the aetiology of these ulcers.\n <\/jats:p>\n \n Design<\/jats:bold>\n : Randomised, double blind, placebo controlled trial.\n <\/jats:p>\n \n Subjects<\/jats:bold>\n : 74 herpes simplex virus seropositive patients aged 18-84. Thirty seven patients received acyclovir (800 mg by mouth daily) and 37 placebo. The patients were examined daily for 28 days.\n <\/jats:p>\n \n Main outcome measures<\/jats:bold>\n : Occurrence of herpes labialis, intraoral ulcers, and acute necrotising ulcerative gingivitis.\n <\/jats:p>\n \n Results<\/jats:bold>\n : The two populations were comparable in age, sex, type of antineoplastic treatment, and history of herpes labialis. Acute oral infections occurred in 25 of the acyclovir treated patients and 36 of the placebo treated patients (relative risk 0.69 (95% confidence interval 0.55 to 0.87)). This difference was due to a reduction in the incidence of herpes labialis (one case versus eight cases; relative risk 0.13 (0.02 to 0.95)), intraoral ulcers excluding the soft palate (one case versus 13 cases; relative risk 0.08 (0.01 to 0.56)), and acute necrotising ulcerative gingivitis (one case versus eight cases; relative risk 0.13 (0.02 to 0.95)). However, ulcers on the soft palate were diagnosed with similar frequency in the two groups. Isolation of herpes simplex virus type 1 in saliva was reduced from 15 cases in the placebo group to one case in the acyclovir group (relative risk 0.07 (0.01 to 0.48)).\n <\/jats:p>\n \n Conclusion<\/jats:bold>\n : Intraoral ulcers excluding the soft palate are most often due to infection with herpes simplex virus, whereas ulcers on the soft palate have a non-herpetic aetiology. The findings suggest that acute necrotising ulcerative gingivitis may also be due to herpes simplex virus. Prophylaxis with acyclovir should be considered for patients with acute myeloid leukaemia during remission induction therapy.\n <\/jats:p>\n \n \n \n Key messages<\/jats:title>\n \n \n Key messages<\/jats:p>\n <\/jats:list-item>\n \n Oral ulcers were found in more than half of patients with acute myeloid leukaemia during remission induction therapy<\/jats:p>\n <\/jats:list-item>\n \n The incidence of herpes labialis, intraoral ulcers outside the soft palate, and acute necrotising ulcerative gingivitis was greatly reduced by prophylaxis with oral acyclovir (800 mg by mouth daily) during remission induction therapy<\/jats:p>\n <\/jats:list-item>\n \n Intraoral ulcers on the soft palate were not associated with herpes virus infection<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>\n <\/jats:boxed-text>\n <\/jats:p>","DOI":"10.1136\/bmj.310.6988.1169","type":"journal-article","created":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T19:34:22Z","timestamp":1319744062000},"page":"1169-1172","source":"Crossref","is-referenced-by-count":39,"title":["Acyclovir given as prophylaxis against oral ulcers in acute myeloid leukaemia: randomised, double blind, placebo controlled trial"],"prefix":"10.1136","volume":"310","author":[{"given":"Olav J","family":"Bergmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svend","family":"Ellermann-Eriksen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soren C","family":"Mogensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorgen","family":"Ellegaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1995,5,6]]},"reference":[{"key":"2025122510165960000_310.6988.1169.1","first-page":"189","article-title":"Acute myeloid and lymphoblastic leukaemia in adults: the course of the disease in 315 patients from one region during a ten-year period.","volume":"36","author":"Johnsen","year":"1989","journal-title":"Dan Med Bull"},{"key":"2025122510165960000_310.6988.1169.2","first-page":"15","article-title":"Oral infections in haematological patients. Pathogenesis and clinical significance.","volume":"39","author":"Bergmann","year":"1992","journal-title":"Dan Med Bull"},{"key":"2025122510165960000_310.6988.1169.3","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1128\/jcm.26.10.2105-2109.1988","article-title":"Oral infections and septicemia in immunocompromised patients with hematologic malignancies.","volume":"26","author":"Bergmann","year":"1988","journal-title":"J Clin Microbiol"},{"key":"2025122510165960000_310.6988.1169.4","doi-asserted-by":"publisher","DOI":"10.1007\/BF01965262"},{"key":"2025122510165960000_310.6988.1169.5","unstructured":"Axell T . A prevalence study of oral mucosal lesions in an adult Swedish population. Odontologisk Revy 1976;27: suppl 36."},{"key":"2025122510165960000_310.6988.1169.6","doi-asserted-by":"publisher","DOI":"10.1007\/BF01963835"},{"key":"2025122510165960000_310.6988.1169.7","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1902\/jop.1986.57.3.141","article-title":"Acute necrotizing ulcerative gingivitis. A review of diagnosis, etiology and treatment.","volume":"57","author":"Johnson","year":"1986","journal-title":"J Periodontol"},{"key":"2025122510165960000_310.6988.1169.8","doi-asserted-by":"crossref","first-page":"681","DOI":"10.3109\/00016356909026317","article-title":"A topographical classification of the oral mucosa suitable for electronic data processing. Its application to 560 leukoplakias.","volume":"27","author":"Roed-Petersen","year":"1969","journal-title":"Acta Odontol Scand"},{"key":"2025122510165960000_310.6988.1169.9","first-page":"405","article-title":"Gingivitis in military personnel with special reference to ulceromembranous gingivitis.","volume":"59","author":"Pindborg","year":"1951","journal-title":"Odontologisk Tidsskrift"},{"key":"2025122510165960000_310.6988.1169.10","unstructured":"Siegel S Castellan NJ Jr .Nonparametric statistics for the behavioral sciences. 2nd ed. New York: McGraw-Hill, 1988."},{"key":"2025122510165960000_310.6988.1169.11","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1136\/bmj.296.6632.1313","article-title":"Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates.","volume":"296","author":"Morris","year":"1988","journal-title":"BMJ"},{"key":"2025122510165960000_310.6988.1169.12","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1136\/bmj.287.6389.384","article-title":"Acyclovir prophylaxis against herpes virus infections in severely immunocompromised patients: randomised double blind trial.","volume":"287","author":"Hann","year":"1983","journal-title":"BMJ"},{"key":"2025122510165960000_310.6988.1169.13","doi-asserted-by":"crossref","first-page":"773","DOI":"10.7326\/0003-4819-99-6-773","article-title":"Acyclovir prophylaxis against herpes simplex infection in patients with leukemia.","volume":"99","author":"Saral","year":"1983","journal-title":"Ann Intern Med"},{"key":"2025122510165960000_310.6988.1169.14","doi-asserted-by":"publisher","DOI":"10.1007\/BF00366060"},{"key":"2025122510165960000_310.6988.1169.15","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1056\/NEJM198107093050202","article-title":"Acyclovir prophylaxis of herpes-simplex-virus infections. A randomised, doubleblind, controlled trial in bone-marrow-transplant recipients.","volume":"305","author":"Saral","year":"1981","journal-title":"N Engl J Med"},{"key":"2025122510165960000_310.6988.1169.16","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1016\/S0140-6736(83)92248-1","article-title":"Prophylaxis of herpes infections after bone-marrow transplantation by oral acyclovir.","volume":"ii","author":"Gluckman","year":"1983","journal-title":"Lancet"},{"key":"2025122510165960000_310.6988.1169.17","doi-asserted-by":"crossref","first-page":"823","DOI":"10.7326\/0003-4819-100-6-823","article-title":"Oral acyclovir for prevention of herpes simplex reactivation after bone marrow transplantation.","volume":"100","author":"Wade","year":"1984","journal-title":"Ann Intern Med"},{"key":"2025122510165960000_310.6988.1169.18","first-page":"137","article-title":"Acyclovir prophylaxis in bone marrow recipients.","volume":"suppl 47","author":"Lundgren","year":"1985","journal-title":"Scand J Infect Dis"},{"key":"2025122510165960000_310.6988.1169.19","doi-asserted-by":"crossref","first-page":"155","DOI":"10.3109\/00365549109024323","article-title":"Alterations in oral microflora and pathogenesis of acute oral infections during remission-induction therapy in patients with acute myeloid leukaemia.","volume":"23","author":"Bergmann","year":"1991","journal-title":"Scand J Infect Dis"},{"key":"2025122510165960000_310.6988.1169.20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1992.tb00634.x"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.310.6988.1169","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.310.6988.1169","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T18:17:12Z","timestamp":1766686632000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.310.6988.1169"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,5,6]]},"references-count":20,"journal-issue":{"issue":"6988","published-online":{"date-parts":[[1995,5,6]]},"published-print":{"date-parts":[[1995,5,6]]}},"alternative-id":["10.1136\/bmj.310.6988.1169"],"URL":"https:\/\/doi.org\/10.1136\/bmj.310.6988.1169","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,5,6]]}}}