Effects of Hematopoietic Stem Cell Transplantation on Dermatology Quality of Life

Abstract

and craniofacial development. Busulfan (Bu) is an alkylating agent that can be combined with cyclophosphamide (Cy) in order to avoid use of TBI in children. The hypothesis to be tested in this study was that children conditioned with Bu/Cy have fewer disturbances in dental development compared to those conditioned with TBI/Cy. Patients and Methods: The present study included 81 recipients of allogeneic HSCT and grafted between January 1980 and 2001. 57 children were treated with TBI and 24 with Bu/Cy. Panoramic radiographs were examined for aplasia, microdontia (reduction in crown size) and disturbances in root development of permanent teeth. Results: When excluding third molars 19% (11/57) in the TBI/ CY-group and 19% (5/28) in the BU/CY-group exhibited one or more missing teeth (p 5 0.7863). In both groups there were a statistically significant negative correlation between age at HSCT and the number of missing teeth (p\0.001). In the TBI/Cy group 23% (13/57) compared to 52% (12/23) in the Bu/Cy group exhibited microdontia (p 5 0.0119). Seventy-three percent (41/56) in the TBI/CY-group compared to 87% (20/23) in the BU/CY-group exhibited disturbances in root development. The mean number of teeth exhibiting disturbances in root development was 12.2 6 9.6 in the TBI/CY-group and 10.3 6 8.6 in the BU/CY-group (p 5 0.5726). Conclusion: The results show that busulfan is as toxic as TBI with regard to causing disturbances in dental development. Long-term survivors need careful dental follow-up to facilitate early diagnosis and planning of dental treatment.