Oral changes in individuals undergoing hematopoietic stem cell transplantation

Area of Science:

• Oral medicine
• Hematology
• Transplantation immunology

Background:

• Hematopoietic stem cell transplantation (HSCT) involves intensive chemotherapy and radiotherapy, leading to severe immunosuppression.
• This immunosuppression significantly increases the risk of oral complications in patients.

Purpose of the Study:

• To establish an oral disease management protocol for patients before and after hematopoietic stem cell transplantation.
• To assess the incidence and severity of oral conditions during the transplantation process.

Main Methods:

• A prospective study involving 65 adult patients with hematological diseases undergoing HSCT (34 allogeneic, 31 autologous).
• Three dental assessments were conducted: pre-transplantation, one week post-infusion, and 100 days post-transplantation.
• Oral changes were scored and categorized by risk level (mild, moderate, severe).

Main Results:

• The most common oral conditions observed were mucositis, gingivitis, pericoronitis, and ulcers.
• Oral mucositis, linked to immunosuppressive drug toxicity, was the predominant disease at one week and 100 days post-transplantation.
• Gingivitis and ulcers were frequent findings during the later assessment period.

Conclusions:

• Oral mucositis significantly increases the risk of clinical complications in HSCT patients.
• Gingivitis, ulcers, and pericoronitis are also identified as potential risk factors for adverse clinical outcomes.
• A structured oral care protocol is essential for managing these complications.