Oral status of patients submitted to autologous hematopoietic stem cell transplantation

• Published in: Supportive care in cancer 2014-01, Vol.22 (1), p.15-21
• Main Authors: Fernandes, Liana Leite Duval, Torres, Sandra R., Garnica, Marcia, de Souza Gonçalves, Lucio, Junior, Arley Silva, de Vasconcellos, Álvaro Copello, Cavalcanti, Wellington, Maiolino, Angelo, de Barros Torres, Maria Cynésia Medeiros
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Bacteremia - blood; Bacteremia - microbiology; Cohort Studies; Dental health; Female; Health aspects; Hematologic Neoplasms - blood; Hematologic Neoplasms - surgery; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic stem cells; Humans; Infection; Male; Medicine; Medicine & Public Health; Middle Aged; Mouth Diseases - diagnosis; Mouth Diseases - microbiology; Mouth Mucosa - pathology; Multiple myeloma; Multiple Myeloma - blood; Multiple Myeloma - surgery; Neutropenia - etiology; Neutropenia - microbiology; Nursing; Nursing Research; Oncology; Oral Hygiene; Original Article; Pain Medicine; Prospective Studies; Rehabilitation Medicine; Stem cells; Stomatitis - blood; Stomatitis - diagnosis; Stomatitis - etiology; Stomatitis - microbiology; Transplantation; Transplants & implants
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-013-1940-2

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.