RELATIONSHIP BETWEEN ORAL HEALTH BEFORE HEMATOPOIETIC STEM CELL TRANSPLANTATION AND ACUTE COMPLICATIONS OF THE TREATMENT

Abstract

Objective: To evaluate the relationship between oral health status before the first allogenic stem cell transplantation (HSCT) and acute complications during the treatment. Study Design: Observational, cross-sectional, retrospective study. The following data were gathered from 42 patients: age, sex, disease; type of HSCT; conditioning; Total Body Index (TBI); oral hygiene (plaque index); periodontal status (PSR), and oral foci of infection. The endpoints for acute complications were: febrile neutropenia; positive hemoculture (at least 2); opioid use; parenteral nutrition; acute graft-vs-host disease (GVHD); mucositis (severity and duration), and oral infection. Results: Of all the patients, 57.14% presented with oral mucositis, 26.20% grade III or IV and 41.66% with duration longer than 7 days. Unsatisfactory oral hygiene resulted in a higher risk for febrile neutropenia (Odds ratio [OR], 5.84; P= .03) and oral infection (OR, 6.0; P = .02). Previous oral foci (OR, 8.0; P = .050) and a higher decayed-missing-filled index (P= .02) were associated with higher incidence of oral infection. Older patients showed a higher risk for febrile neutropenia while malignant diseases and myeloablative conditioning had higher risk for mucositis severity and duration. Conclusion: This work was unprecedented in showing the influence of the oral health condition and oral hygiene in increasing the risk of oral infection and fever during the acute phase of HSCT.