PDF: Oral management of adult patients undergoing hematopoietic stem cell transplantation


Chemotherapy and hematopoietic stem cell transplantation (HSCT) are the current treatments for patients with hematological diseases; they result in myelosuppression, and increase the susceptibility of patients to severe infections. 



The oral cavity is a potential site of complications in HSCT patients, because it is
the entrance for agents that can cause systemic infections; it is one of the most frequent locations for side effects deriving from conditioning therapy. 


The importance of dental pre-chemotherapy and transplant prescription is often stressed, since both therapies depress the immune system and platelets, making each intervention at this stage a high risk. The aim of this article is to review the potential complications of HSCT, and to extrapolate from the scientific literature the treatments and timeframes in which dental therapies can be performed, avoiding important risks for patients.

The feasibility of performing certain dental procedures in patients undergoing hematopoietic stem cell transplantation (HSCT) depends on the overall state of the patient’s health, as well as the stage of the disease and/or antineoplastic therapy or HSCT. 

HSCT is widely used in the treatment of disorders of the hematopoietic system or, most commonly, of malignancies such as lymphoma, myeloma, and leukemia. It represents a valid therapeutic option for aplastic anemia congenital
immune deficiency states, lysosomal accumulation disorders (Gaucher’s disease) and congenital leukocyte affections (Kostmann’s syndrome).

This procedure has been successfully extended to patients with solid tumors and autoimmune diseases such as multiple sclerosis.

Department of Clinical Science and Translational Medicine, University of Rome, Tor Vergata, Rome, Italy Oral Surgery and Implantology Unit, Catholic University of Sacred Heart, Gemelli Foundation,
School of Medicine, Rome, Italy