Oral disease burden in children and adolescents scheduled for allogeneic haematopoietic stem cell transplantation: a multicentre study.
In a prospective multicentre cohort of 91 patients under 18 years scheduled for allogeneic HSCT, 49% reported oral symptoms, 37% had dental caries, and substantial proportions underwent pre-transplant extractions or restorations.
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In a prospective multicentre cohort of 91 patients under 18 years scheduled for allogeneic HSCT, 49% reported oral symptoms, 37% had dental caries, and substantial proportions underwent pre-transplant extractions or restorations.
Research significance
The study directly supports a substantial and potentially actionable pre-transplant oral disease burden; it is reasonable—but not demonstrated by this record—to hypothesize that systematic dental evaluation and treatment before allogeneic HSCT could reduce infectious or other post-transplant complications.
Source abstract
PURPOSE: Haematopoietic stem cell transplantation (HSCT) is a curative treatment for haematological malignancies and non-malignant haematological and immunological disorders. The oral cavity, which serves as a reservoir for infection, poses additional risks for patients undergoing HSCT. This study aimed to assess the oral disease burden among children and adolescents undergoing allogeneic HSCT (aHSCT) and to evaluate the oral healthcare they received before transplantation. METHODS: This prospective, longitudinal, multicentre cohort study included 91 children and adolescents under 18 years of age who were scheduled for an aHSCT. RESULTS: The mean age of the cohort was 11.2 ± 4.6 years, with acute leukaemia the most common diagnosis (47%), followed by non-malignant haematological disorders (15%). The prevalence of patient-reported oral symptoms was 49%, with sensitivity to hot and cold (10%) and loose teeth (7%) the most common complaints. Dental caries was present in 37%, and 13% had visible dental plaque on more than half of their teeth. Dental extractions were performed in 24% of patients, and 22% received dental restorations. CONCLUSION: Children and adolescents scheduled for aHSCT face a significant burden of oral disease, with notable dental issues that must be addressed before transplantation. This study underscores the importance of pre-transplant dental evaluations to address remaining dental concerns and minimise post-transplant complications.