title: Oral status of patients submitted to autologous hematopoietic stem cell transplantation.
abstract: OBJECTIVE
  Oral infection may be a source of bacteremia in patients undergoing hematopoietic stem cell transplant (HSCT). The aim of this study was to evaluate the relationship between patients with poor periodontal status and complications after HSCT.
  
  
  METHODS
  A cohort of patients with hematological malignancies candidates for autologous HSCT was observed before and during the neutropenic phase of HSCT. A primary evaluation was performed before the HSCT procedure, including medical and socio-demographic data and physical examination (number of teeth and decayed, missing and filled teeth index (DMFT), oral mucosa, and full mouth periodontal assessment). During the neutropenic phase, data regarding the development of febrile neutropenia, bacteremia, and mucositis were also prospectively obtained.
  
  
  RESULTS
  Forty-eight patients were included. The most common baseline disease was multiple myeloma (70 %). In the primary evaluations, the median DMFT was 13 (ranging 0-27), and periodontitis and gingivitis were present in 29 and 60 % of the patients, respectively. During the neutropenic phase of HSCT, fever occurred in 96 % of patients, and bacteremia was documented in 29 %. Coagulase-negative Staphylococcus was the most common isolated bacteria. Patients who developed bacteremia had a higher frequency of oral disorders compared with those without bacteremia, but it was not statistically significant. Oral mucositis affected 89.6 % of the patients, and patients with gingivitis or periodontal disorders had a high frequency of mucositis.
  
  
  CONCLUSIONS
  The prevalence of oral pathologic conditions previous to HSCT procedures was very high in the studied population. A possible association was noted between previous gingivitis and the development of mucositis during the neutropenia of HSCT.
authors: Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Liana Leite Duval
authors: LL
authors: Fernandes
authors: Sandra R
authors: SR
authors: Torres
authors: Marcia
authors: M
authors: Garnica
authors: Lucio
authors: L
authors: de Souza Gonçalves
authors: Arley Silva
authors: AS
authors: Junior
authors: Álvaro Copello
authors: ÁC
authors: de Vasconcellos
authors: Wellington
authors: W
authors: Cavalcanti
authors: Angelo
authors: A
authors: Maiolino
authors: Maria Cynésia Medeiros
authors: MC
authors: de Barros Torres
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000097:blood / Q000382:microbiology; D015331:Cohort Studies; D005260:Female; D019337:Hematologic Neoplasms / Q000097:blood / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000175:diagnosis* / Q000382:microbiology; D009061:Mouth Mucosa / Q000473:pathology; D009101:Multiple Myeloma / Q000097:blood / Q000601:surgery; D009503:Neutropenia / Q000209:etiology / Q000382:microbiology; D009910:Oral Hygiene; D011446:Prospective Studies; D013280:Stomatitis / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology
references: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Mar;107(3):301-12
references: 19217013
references: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Nov;94(5):581-8
references: 12424452
references: J Dent Educ. 2001 Apr;65(4):313-21
references: 11336116
references: Clin Infect Dis. 2002 May 15;34(10):1386-90
references: 11981735
references: Infect Dis Clin North Am. 1999 Dec;13(4):901-23
references: 10579115
references: Oral Surg Oral Med Oral Pathol. 1989 Dec;68(6):711-6
references: 2594318
references: J Periodontol. 2008 Jan;79(1):181-6
references: 18166109
references: Bone Marrow Transplant. 2000 Jan;25(1):59-65
references: 10654016
references: NCI Monogr. 1990;(9):1-184
references: 2188147
references: J Oral Pathol Med. 1989 Jan;18(1):54-8
references: 2746518
references: Cancer. 2004 May 1;100(9 Suppl):2026-46
references: 15108223
references: Oral Dis. 2008 May;14(4):356-66
references: 18410578
references: N Engl J Med. 2005 Sep 8;353(10):977-87
references: 16148283
references: Cancer. 1992 May 15;69(10):2469-77
references: 1568168
references: Bone Marrow Transplant. 2001 Mar;27(5):537-42
references: 11313689
references: Bone Marrow Transplant. 1999 Jan;23(1):27-33
references: 10037047
references: Support Care Cancer. 1999 Jan;7(1):17-20
references: 9926969
references: J Periodontol. 2000 Mar;71(3):394-402
references: 10776926
references: Transpl Infect Dis. 2003 Dec;5(4):167-73
references: 14987200
references: Support Care Cancer. 2009 May;17(5):581-7
references: 19015893
references: Haematologica. 2009 Feb;94(2):163-6
references: 19181789
references: Dent Clin North Am. 2006 Oct;50(4):659-76, viii
references: 17000279
references: J Hosp Infect. 2008 Mar;68(3):203-7
references: 18289729
references: Bone Marrow Transplant. 2006 Aug;38(3):237-42
references: 16850033
references: Periodontol 2000. 2007;44:44-54
references: 17474925
references: Bone Marrow Transplant. 2007 Jun;39(12):775-81
references: 17438585
references: J Infect Dis. 1990 Mar;161(3):397-401
references: 2179421
references: Clin Oral Investig. 2003 Jun;7(2):113-5
references: 12768464
references: Clin Infect Dis. 2001 Oct 1;33(7):947-53
references: 11528564
references: Support Care Cancer. 2003 Oct;11(10):674-7
references: 12883964
references: Support Care Cancer. 2006 Feb;14(2):137-46
references: 16041502
references: Am J Hematol. 2012 Jul;87(7):729-31
references: 22566293
references: Bone Marrow Transplant. 2001 Mar;27(5):525-9
references: 11313687
references: Ann Hematol. 2002 Jul;81(7):374-7
references: 12185506
references: Cancer. 2007 Mar 1;109(5):820-31
references: 17236223
references: J Pain Symptom Manage. 2008 May;35(5):508-14
references: 18242047
references: Int J Oral Maxillofac Surg. 2002 Apr;31(2):170-2
references: 12102415
references: Eur J Cancer B Oral Oncol. 1994;30B(2):93-7
references: 8032307
references: Cancer Nurs. 1989 Oct;12(5):265-70
references: 2804961
references: Bone Marrow Transplant. 2004 Apr;33(7):745-9
references: 14743196