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Dental status and risk of odontogenic complication in patients undergoing hematopoietic stem cell transplant

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Abstract

Purpose

Dental evaluation and management prior to hematopoietic stem cell transplant (HSCT) plays a vital role in identifying and treating infections that may be life-threatening. The purpose of this study is to describe the dental management of patients undergoing pre-HSCT examination with the Dental Service at Memorial Sloan Kettering Cancer Center (MSKCC) and to report on odontogenic complications.

Methods

Patients referred for evaluation as part of the standard preparation for HSCT were included. Following clinical and radiological examination, patients were assigned to one of three groups based on risk of odontogenic infection, and treatment was provided as indicated. Patients were followed, and their medical records were reviewed for odontogenic complications during the transplant admission.

Results

Of the 375 patients evaluated, 350 patients underwent HSCT: allogeneic 143 (40.9%) and autologous 207 (59.1%). The distribution of primary cancer diagnosis was as follows: multiple myeloma 104 (29.7%), leukemias 95 (27.1%), Hodgkin’s lymphoma 28 (8.0%), non-Hodgkin’s Lymphoma 99 (28.3%), and other conditions 24 (6.9%). The median time from dental evaluation to transplant was 29 days. The median Decayed, Missing, Filled Teeth Index was 17. The median Community Periodontal Index was 1. Based on dental status, 145 patients (41.4%) were classified as low risk, 133 (38%) as moderate risk and 72 (20.6%) as high risk of odontogenic infection. One hundred fourteen patients (32.6%) required dental treatment prior to HSCT, and 100 of these (28.6%) completed treatment. Two (0.57%) patients had odontogenic complications.

Conclusions

With conservative pre-HSCT dental treatment based on an infection risk classification system, a low odontogenic complication rate was observed.

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The authors affirm that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.

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Acknowledgments

The authors would like to thank Kant Wu for his efforts and contributions to this project.

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Authors and Affiliations

  1. Department of Surgery, Division of Oral & Maxillofacial Surgery and Dentistry, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA

    Heidi J. Hansen

  2. Dental Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Cherry Estilo, Armand Karl Solano, Joseph Randazzo, Joseph Huryn & SaeHee K. Yom

  3. Missouri School of Dentistry and Oral Health, Kirksville, MO, USA

    Adepitan Owosho

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  1. Heidi J. Hansen
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  2. Cherry Estilo
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Heidi J. Hansen and SaeHee K.Yom. The first draft of the manuscript was written by Heidi J. Hansen, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Heidi J. Hansen.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the ethics committee of Memorial Sloan Kettering Cancer Center.

Consent to participate

An exemption and waiver of informed consent was granted for this study by the Institutional Review Board of Memorial Sloan Kettering Cancer Center.

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Hansen, H.J., Estilo, C., Owosho, A. et al. Dental status and risk of odontogenic complication in patients undergoing hematopoietic stem cell transplant. Support Care Cancer 29, 2231–2238 (2021). https://doi.org/10.1007/s00520-020-05733-1

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