Common oral diseases, hyposalivation and survival post‐HSCT, a longitudinal study

Uutela, Pauliina; Passweg, Jakob; Gerull, Sabine; Weiger, Roland; Mauramo, Elina; Waltimo, Tuomas; Mauramo, Matti

doi:10.1111/ejh.13283

Cited by 10 publications

(20 citation statements)

References 42 publications

(175 reference statements)

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“…was 17.1, and the mean number of decayed surfaces was 1.4 (SD: 2.2), which is in line with a Dutch population of comparable age groups [Vermaire and Schuller, 2019]. Previous publications reported a broad range of DMFT scores before autologous and allogeneic HSCT, varying between 7.0 [Ertas et al, 2014] and 18.9 [Uutela et al, 2019a]. These broad variations might reflect differences in patient selection and oral health care systems in different countries and emphasize the difficulties when comparing different populations of HSCT recipients.…”

Section: Discussionsupporting

confidence: 84%

“…The SWS flow rate of patients with caries progression was over time 26% lower in comparison to patients without caries progression. Recently, it was concluded that caries prevalence was consistently but not significantly higher in patients with hyposalivation 6, 12, and 24 months post-HSCT [Uutela et al, 2019a].…”

Section: Discussionmentioning

confidence: 99%

“…A difference in flow rates of 1 year post-HSCT between patients that developed or did not develop new caries lesions could not be established [Heimdahl et al, 1985]. In another study, caries was more prevalent in patients with hyposalivation 6, 12, and 24 months post-treatment, but the difference was not significant [Uutela et al, 2019a].…”

Section: Introductionmentioning

confidence: 91%

“…Longitudinal studies that confirm the relation between HSCT and development of dental caries are scarce. A number of prospective studies did not notice an increase in DMFT score or new caries lesions after a follow-up of 3 months [Barrach et al, 2015;Boer et al, 2015] or 24 months [Uutela et al, 2019a]. Only one study reported an increase in DMFT score 6 months post-HSCT: 51 new lesions developed in teeth that were previously sound in 36 patients [Ertas et al, 2014].…”

Section: Introductionmentioning

confidence: 98%

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Caries Progression after Haematopoietic Stem Cell Transplantation and the Role of Hyposalivation

Bulthuis¹,

Gennip²,

Thomas³

et al. 2022

Caries Res

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Haematopoietic stem cell transplantation (HSCT) preceded by a conditioning regimen is an established treatment option for many haematological diseases. Decreased salivary flow rates after HSCT may increase caries risk. We aim to estimate the extent to which caries lesions develop or progress in adult HSCT recipients and assess its association with salivary flow rate. A multi-centre prospective observational study was conducted in which patients receiving HSCT were followed up for 18 months. We included 116 patients (median age 56 years, 43% female) from two medical centres in the Netherlands. Unstimulated (UWS) and stimulated (SWS) whole saliva was collected and full caries charts were made before HSCT and 3, 6, 12 and 18 months post-HSCT. Caries was scored according to the ICDAS criteria by trained dentist-examiners. New dentine lesions or lesion progression into dentine (ICDAS ≥4 or cavitated root lesions) occurred in 32% of patients over 18 months. The median number of affected surfaces was 2 (range: 1 – 12) per patient with caries progression. The influence of hyposalivation of unstimulated saliva (<0.2 mL/min) and stimulated saliva (<0.7 mL/min) at baseline and after 3 months on caries progression was determined with a negative binomial regression model. Hyposalivation of SWS 3 months after HSCT was a significant risk indicator for caries progression (incidence rate ratio: 5.30, 95% CI: 2.09 – 13.4, p < 0.001), while hyposalivation of SWS at baseline and hyposalivation of UWS were not. We conclude that caries progression is a common oral complication in patients after HSCT, and stimulated hyposalivation shortly after treatment is a significant risk indicator for caries progression.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Caries Progression after Haematopoietic Stem Cell Transplantation and the Role of Hyposalivation

Bulthuis¹,

Gennip²,

Thomas³

et al. 2022

Caries Res

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“…Hematopoietic cell transplantation (HCT) is the treatment of choice for a number of malignant and non‐malignant diseases involving the hematopoietic system and for some solid tumours (Gratwohl et al., 2011; Passweg et al., 2012). The treatment is, however, often associated with several oral side effects including oral mucositis, oral infections, alterations in taste and in saliva quantity and composition (Passweg et al., 2012; Sonis et al., 2001, 2004; Uutela et al., 2019). Graft‐versus‐host disease (GVHD) is a common complication of allogenic HCT (allo‐HCT), affecting multiple organ systems and causing significant morbidity and mortality (Kuten‐Shorrer et al., 2014; Lee et al., 2003; Presland, 2017).…”

Section: Introductionmentioning

confidence: 99%

Salivary BPIFA proteins are altered in patients undergoing hematopoietic cell transplantation

et al. 2021

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Objective The aim of this study was to evaluate the expression of BPIFA proteins in the saliva and salivary glands of hematopoietic cell transplant (HCT) patients. Material and Methods This longitudinal study included patients who had undergone autologous HCT (auto‐HCT) and allogeneic HCT (allo‐HCT), and unstimulated saliva was collected at three time points, with a fourth collection at oral chronic graft‐versus‐host disease (cGVHD) onset. BPIFA expression was analysed by Western blotting in saliva and immunostaining in the minor salivary glands of cGVHD patients. Results Auto‐HCT patients showed increased levels of BPIFA1 (p = .021) and BPIFA2 at D+7 (p = .040), whereas allo‐HCT group demonstrated decreased expression of BPIFA2 at D+8 (p = .002) and at D+80 (p = .001) and a significant association between BPIFA2 low levels and hyposalivation was observed (p = .02). BPIFA2 was significantly lower in the cGVHD patients when compared to baseline (p = .04). Conclusions The results of this study show distinct pattern of expression of BPIF proteins in both auto‐HCT and allo‐HCT recipients with decreased levels of BPIFA2 during hyposalivation and cGVHD. Further studies are necessary to elucidate these proteins mechanisms and their clinical implications in these groups of patients.

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The effect of hematopoietic stem cell transplantation on patient-reported subjective oral dryness: a systematic review focusing on prevalence, severity and distress

Bulthuis

Gennip

Bronkhorst

et al. 2023

Support Care Cancer

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Objective The aim of the present systematic review is to assess the prevalence and severity of and distress caused by xerostomia over time in adult hematopoietic stem cell transplantation (HSCT) recipients. Methods PubMed, Embase, and the Cochrane Library were searched for papers published between January 2000 and May 2022. Clinical studies were included if patient-reported subjective oral dryness was reported in adult autologous or allogeneic HSCT recipients. Risk of bias was assessed according to a quality grading strategy published by the oral care study group of the MASCC/ISOO, resulting in a score between 0 (highest risk of bias) and 10 (lowest risk of bias). Separate analysis focused on autologous HSCT recipients, allogeneic HSCT recipients receiving a myeloablative conditioning (MAC), and those receiving a reduced intensity conditioning (RIC). Results Searches yielded 1792 unique records; 22 studies met the inclusion criteria. The quality scores ranged between 1 and 7, with a median score of 4. The prevalence, severity, and distress of xerostomia increased shortly after HSCT. Severity of xerostomia in allogeneic MAC recipients was higher compared to allogeneic RIC recipients 2–5 months post-HSCT (mean difference: 18 points on 0–100 scale, 95% CI: 9–27); after 1–2 years, there was no significant difference anymore. Conclusion The prevalence of xerostomia in HSCT recipients is high in comparison to the general population. The severity of complaints is raised during the first year post-HSCT. The intensity of the conditioning plays a key role in the short-term development of xerostomia, while factors affecting the recovery in the long term remain largely unknown.

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Common oral diseases, hyposalivation and survival post‐HSCT, a longitudinal study

Cited by 10 publications

References 42 publications

Caries Progression after Haematopoietic Stem Cell Transplantation and the Role of Hyposalivation

Caries Progression after Haematopoietic Stem Cell Transplantation and the Role of Hyposalivation

Salivary BPIFA proteins are altered in patients undergoing hematopoietic cell transplantation

The effect of hematopoietic stem cell transplantation on patient-reported subjective oral dryness: a systematic review focusing on prevalence, severity and distress

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