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

Eur J Haematol. 2019 Oct;103(4):300-306. doi: 10.1111/ejh.13283. Epub 2019 Jul 11.

Abstract

Objectives: Haematopoietic stem cell transplantation (HSCT) recipients are at risk of side effects within the oral cavity. The purpose of this study was to examine progression of common oral diseases and hyposalivation and their associations with survival in allogeneic HSCT recipients.

Methods: Two hundred and sixty nine adult HSCT recipients treated with HSCT between 2008 and 2016 were included in this study. The associations of caries, decayed, missing, filled teeth (DMFT) index, radiological attachment loss and stimulated salivary flow rate with 6-month survival and the progression of the oral disorders within 2 years were examined.

Results: Forty HSCT recipients (14.8%) deceased within 6 months post-HSCT. Among the deceased recipients, hyposalivation and caries were more common pre-HSCT than in recipients who survived over 6 months (P < 0.05). HSCT recipients with hyposalivation pre-HSCT had higher risk of death (HR: 1.90, 95% CI:1.00-3.60; P = 0.044) within 6 months post-HSCT compared with recipients without hyposalivation. Hyposalivation pre-HSCT was associated with a higher DMFT index score (P < 0.05) and a smaller number of teeth (P < 0.005) 24 months post-HSCT in comparison with those without hyposalivation.

Conclusions: Hyposalivation and caries were associated with a lower rate of survival in HSCT recipients. Additionally, hyposalivation predisposed to deterioration of oral health post-HSCT.

Keywords: dental caries; dmf index; graft vs host disease; haematology; hyposalivation; stem cell transplantation.

MeSH terms

  • Adult
  • Aged
  • Female
  • Graft vs Host Disease / diagnosis
  • Graft vs Host Disease / etiology
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mouth Diseases / diagnosis
  • Mouth Diseases / epidemiology*
  • Mouth Diseases / etiology*
  • Prognosis
  • Survival Rate
  • Treatment Outcome
  • Xerostomia / diagnosis
  • Xerostomia / epidemiology*
  • Xerostomia / etiology*
  • Young Adult