Supportive Care in Cancer

, Volume 22, Issue 1, pp 15–21

Oral status of patients submitted to autologous hematopoietic stem cell transplantation

Authors

  • Liana Leite Duval Fernandes
    • Universidade Federal do Rio de Janeiro
    • Department of Oral Pathology and Diagnosis, School of DentistryUniversidade Federal do Rio de Janeiro
    • Oral Health Program, Clementino Fraga Filho HospitalUniversidade Federal do Rio de Janeiro
  • Marcia Garnica
    • Hematology Service, Hospital Universitário Clementino Fraga FilhoUniversidade Federal do Rio de Janeiro
  • Lucio de Souza Gonçalves
    • Oral Health Program, Clementino Fraga Filho HospitalUniversidade Federal do Rio de Janeiro
  • Arley Silva Junior
    • Department of Oral Pathology and Diagnosis, School of DentistryUniversidade Federal do Rio de Janeiro
    • Oral Health Program, Clementino Fraga Filho HospitalUniversidade Federal do Rio de Janeiro
  • Álvaro Copello de Vasconcellos
    • Hematology Service, Hospital Universitário Clementino Fraga FilhoUniversidade Federal do Rio de Janeiro
  • Wellington Cavalcanti
    • Dental DepartmentInstituto de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO)
  • Angelo Maiolino
    • Hematology Service, Hospital Universitário Clementino Fraga FilhoUniversidade Federal do Rio de Janeiro
  • Maria Cynésia Medeiros de Barros Torres
    • Departmentof Dental Clinic, School of DentistryUniversidade Federal do Rio de Janeiro
Original Article

DOI: 10.1007/s00520-013-1940-2

Cite this article as:
Fernandes, L.L.D., Torres, S.R., Garnica, M. et al. Support Care Cancer (2014) 22: 15. doi:10.1007/s00520-013-1940-2

Abstract

Purpose

Oral infection may be a source of bacteremia in patients undergoing hematopoietic stem cell transplant (HSCT). The aim of this study was to evaluate the relationship between patients with poor periodontal status and complications after HSCT.

Methods

A cohort of patients with hematological malignancies candidates for autologous HSCT was observed before and during the neutropenic phase of HSCT. A primary evaluation was performed before the HSCT procedure, including medical and socio-demographic data and physical examination (number of teeth and decayed, missing and filled teeth index (DMFT), oral mucosa, and full mouth periodontal assessment). During the neutropenic phase, data regarding the development of febrile neutropenia, bacteremia, and mucositis were also prospectively obtained.

Results

Forty-eight patients were included. The most common baseline disease was multiple myeloma (70 %). In the primary evaluations, the median DMFT was 13 (ranging 0–27), and periodontitis and gingivitis were present in 29 and 60 % of the patients, respectively. During the neutropenic phase of HSCT, fever occurred in 96 % of patients, and bacteremia was documented in 29 %. Coagulase-negative Staphylococcus was the most common isolated bacteria. Patients who developed bacteremia had a higher frequency of oral disorders compared with those without bacteremia, but it was not statistically significant. Oral mucositis affected 89.6 % of the patients, and patients with gingivitis or periodontal disorders had a high frequency of mucositis.

Conclusions

The prevalence of oral pathologic conditions previous to HSCT procedures was very high in the studied population. A possible association was noted between previous gingivitis and the development of mucositis during the neutropenia of HSCT.

Keywords

Hematopoietic stem cell transplantationPeriodontal diseasesOral mucositisGingivitisBacteremia

Copyright information

© Springer-Verlag Berlin Heidelberg 2013