Dental management prior to hematopoietic stem cell transplantation.
The authors investigated oral health treatment in patients scheduled for hematopoietic stem cell transplantation. Fifteen patients were scheduled for bone marrow transplantation: 12 had leukemia, two had aplastic anemia, and one had myelodysplastic syndrome. Twenty-three patients were scheduled to undergo peripheral blood stem cell transplantation: 20 had malignant lymphoma and three had leukemia. Patients with platelet counts of < or = 50,000/mm3 who required tooth extraction and those with platelet counts of < or = 30,000 /mm3 who required scaling received platelet transfusions before the dental treatment. We saw no bleeding problems in these patients. Dental care for patients who had neutrophil counts of > or = 500/mm3 included tooth extractions or scaling, with no postoperative infection. Even those with severe immunosuppression (neutrophil count: 100-150/mm3) tolerated treatment when prophylactic measures, such as intravenous administration of antibiotics, were used. One patient with a neutrophil count of < or = 50/mm3 developed an infection after even conservative therapy. Thus, caution should be exercised when treating patients scheduled for HSCT as even conservative therapy can initiate and infection.
Morimoto
Yoshinari
Y
Department of Dental Anesthesiology, Graduate School of Dentistry, Osaka University, 1-8, Yamadaoka, Suita, Osaka 565-0871, Japan. ysn-mori@dent.osaka-u.ac.jp
Niwa
Hitoshi
H
Imai
Yuichiro
Y
Kirita
Tadaaki
T
D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy; D019072:Antibiotic Prophylaxis; D016026:Bone Marrow Transplantation; D017742:Dental Care for Chronically Ill; D003793:Dental Restoration, Permanent; D012534:Dental Scaling; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007938:Leukemia / Q000628:therapy; D007958:Leukocyte Count; D008223:Lymphoma / Q000628:therapy; D008297:Male; D009190:Myelodysplastic Syndromes / Q000628:therapy; D009504:Neutrophils / Q000473:pathology; D009910:Oral Hygiene; D036102:Peripheral Blood Stem Cell Transplantation; D010976:Platelet Count; D017713:Platelet Transfusion; D014081:Tooth Extraction