Supportive Care in Cancer

, Volume 22, Issue 1, pp 15–21 | Cite as

Oral status of patients submitted to autologous hematopoietic stem cell transplantation

  • Liana Leite Duval Fernandes
  • Sandra R. Torres
  • Marcia Garnica
  • Lucio de Souza Gonçalves
  • Arley Silva Junior
  • Álvaro Copello de Vasconcellos
  • Wellington Cavalcanti
  • Angelo Maiolino
  • Maria Cynésia Medeiros de Barros Torres
Original Article



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.


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.


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.


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.


Hematopoietic stem cell transplantation Periodontal diseases Oral mucositis Gingivitis Bacteremia 



This work was supported by FAPERJ (Fundação de Amparo a Pesquisa do Estado do Rio de Janeiro) and CNPq (Conselho Nacional do Desenvolvimento Cientifico e Tecnológico).

Conflict of interest

The authors declare no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Liana Leite Duval Fernandes
    • 1
    • 2
  • Sandra R. Torres
    • 3
    • 4
  • Marcia Garnica
    • 5
  • Lucio de Souza Gonçalves
    • 4
  • Arley Silva Junior
    • 3
    • 4
  • Álvaro Copello de Vasconcellos
    • 5
  • Wellington Cavalcanti
    • 6
  • Angelo Maiolino
    • 5
  • Maria Cynésia Medeiros de Barros Torres
    • 7
  1. 1.Universidade Federal do Rio de JaneiroRio de JaneiroBrazil
  2. 2.São PauloBrazil
  3. 3.Department of Oral Pathology and Diagnosis, School of DentistryUniversidade Federal do Rio de JaneiroRio de JaneiroBrazil
  4. 4.Oral Health Program, Clementino Fraga Filho HospitalUniversidade Federal do Rio de JaneiroRio de JaneiroBrazil
  5. 5.Hematology Service, Hospital Universitário Clementino Fraga FilhoUniversidade Federal do Rio de JaneiroRio de JaneiroBrazil
  6. 6.Dental DepartmentInstituto de Hematologia Arthur de Siqueira Cavalcanti (HEMORIO)Rio de JaneiroBrazil
  7. 7.Departmentof Dental Clinic, School of DentistryUniversidade Federal do Rio de JaneiroRio de JaneiroBrazil

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