Long-term adverse effects of hematopoietic stem cell transplantation on dental development in children

Voskuilen, I. G. M. van der Pas-van; Veerkamp, J.S.J.; Raber-Durlacher, Judith E.; Bresters, Dorine; Wijk, Arjen J. van; Barasch, Andrei; McNeal, Sandre F.; Gortzak, Richmond A. Th.

doi:10.1007/s00520-008-0567-1

Cited by 42 publications

(39 citation statements)

References 36 publications

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“…In the present survey, the prevalence of pulmonary late effects was relatively low probably because the proportion of allogeneic SCTs was 72% (33/46) when compared with 100% allogeneic SCTs in Bresters' study [23]. The prevalence of dental late effects was also relatively low in our survey probably because insufficient data were available for the evaluation of dental late effects, as regular dental checkups are not commonly performed during long-term follow-ups at clinics in Japan [25]. In our study, a duration after therapy completion of C15 years, presence of solid tumors, the use of radiotherapy, 1 or more recurrence of cancers, and SCT were determined as independent significant risk factors for the development of late effects by multivariate logistic regression analysis.…”

Section: Discussioncontrasting

confidence: 53%

“…Risk factors for underweight were total body irradiation (TBI) (OR 5.13; p \ 0.001) and chest/abdomen irradiation (OR 4.28; p = 0.025). In the CCS group treated without SCT, 10% of female and 20% of male patients were overweight (BMI [ 25). The characteristics of the patients belonging to the CCS groups treated with or without SCT are shown in Table 2.…”

Section: Resultsmentioning

confidence: 99%

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Late effects and quality of life of childhood cancer survivors: Part 1. Impact of stem cell transplantation

et al. 2010

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To examine the late effects and health-related quality of life among childhood cancer survivors (CCS) after stem cell transplantation (SCT), we performed a cross-sectional survey using self-rating questionnaires. The subjects were divided into 3 groups: SCT-treated CCS, CCS treated without SCT, and the general population who matched for age, gender, residential area, and work status with the CCS. We analyzed the questionnaires of 185 CCS and 1,000 control participants. The median ages of CCS at diagnosis and survey were 8 and 22 years, respectively. The mean final heights of male and female participants were significantly lower for SCT-treated CCS than for CCS treated without SCT and the controls. Among the SCT-treated CCS, >40% were underweight (BMI < 18.5). Late effects were observed in 78% of SCT-treated CCS versus 45% of CCS treated without SCT. Multivariate analysis revealed that >15 years' duration after therapy completion (OR 2.95; p = 0.014), solid tumors (4.31; p = 0.040), radiotherapy (2.82; p = 0.009), recurrence (4.22; p = 0.017), and SCT (3.39; p = 0.014) were significant risk factors for late effects. Subjective symptoms were significantly frequent in SCT-treated CCS. Physical dysfunction, psychological stress, and social adaptation problems were observed in >70% of SCT-treated CCS.

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Section: Discussioncontrasting

confidence: 53%

Section: Resultsmentioning

confidence: 99%

Late effects and quality of life of childhood cancer survivors: Part 1. Impact of stem cell transplantation

et al. 2010

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“…Also excessive caries and dry mouth was found in 13 of these 40 children (2 of 13 children with dry mouth had cGVHD). 28 A conditioning regimen including irradiation either as TBI or TAI proved to be a risk factor for a higher burden of late effects. This has also been found in other studies.…”

Section: Discussionmentioning

confidence: 99%

High burden of late effects after haematopoietic stem cell transplantation in childhood: a single-centre study

Bresters

Gils

Kollen

et al. 2009

Bone Marrow Transplant

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The aim of our study was to assess the cumulative incidence and severity ('burden') of late effects in a single-centre cohort of childhood haematopoietic stem cell transplantation (HSCT) survivors, at least 2 years after transplantation. The presence and severity of late effects in each survivor was documented according to the Common Terminology Criteria for Adverse Events (version 3.0). The burden of late effects was graded from mild to disabling/life-threatening. Risk factors for a high burden of late effects were assessed by univariate and multivariate logistic regression analyses. Among 162 survivors of HSCT seen in our late effects outpatient clinic, cumulative incidence of late effects was 93.2% after a median followup time of 7.2 years (range 2.0-21.0 years) after HSCT. The burden of late effects was mild, moderate, severe and disabling in 28, 41, 24 and 1% of survivors respectively. Risk factors for a severe or disabling burden of late effects were older age at HSCT (P for trend o0.001) and a conditioning regimen including irradiation OR 2.2, 95% CI 1.1-4.7, P ¼ 0.03). In conclusion, a high burden of late effects is found in childhood HSCT survivors after a median follow-up of only 7 years.

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“…The effects of cancer treatment in the later stages of tooth formation are characterized by disturbed root development (43). The first signs of root development in permanent teeth are observed on panoramic radiographs beginning approximately at age 3 years (central incisors and permanent first molars) to age 7.5 years (permanent second molars) (43) and root formation is completed after the tooth has erupted into the oral cavity (46). Changes in odontoblast activity caused by abnormal secretory functioning of the dentin microtubules and complex changes in inter- and intracellular relationships can produce shortened, tapered and blunted roots (42) (Figure 3).…”

Section: Introductionmentioning

confidence: 99%

Dental anomalies in children submitted to antineoplastic therapy

Carrillo¹,

Corrêa²,

Lopes³

et al. 2014

Clinics

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Cancer is the third most frequent cause of death in children in Brazil. Early diagnosis and medical advances have significantly improved treatment outcomes, which has resulted in higher survival rates and the management of late side effects has become increasingly important in caring for these patients. Dental abnormalities are commonly observed as late effects of antineoplastic therapy in the oral cavity. The incidence and severity of the dental abnormalities depend on the child's age at diagnosis and the type of chemotherapeutic agent used, as well as the irradiation dose and area. The treatment duration and aggressivity should also be considered. Disturbances in dental development are characterized by changes in shape, number and root development. Enamel anomalies, such as discoloration, opacities and hypoplasia are also observed in these patients. When severe, these abnormalities can cause functional and esthetic sequelae that have an impact on the children's and adolescents' quality of life. General dentists and pediatric dentists should understand these dental abnormalities and how to identify them aiming for early diagnosis and appropriate treatment.

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Long-term adverse effects of hematopoietic stem cell transplantation on dental development in children

Cited by 42 publications

References 36 publications

Late effects and quality of life of childhood cancer survivors: Part 1. Impact of stem cell transplantation

Late effects and quality of life of childhood cancer survivors: Part 1. Impact of stem cell transplantation

High burden of late effects after haematopoietic stem cell transplantation in childhood: a single-centre study

Dental anomalies in children submitted to antineoplastic therapy

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