Oral repercussions in patients undergoing hematopoietic stem cell transplantations: An integrative review of the literature

Authors

DOI:

https://doi.org/10.33448/rsd-v12i11.43882

Keywords:

Mucositis; Xerostomia; Dental care; Hematopoietic stem cell transplantation; Oral manifestations; Dysgeusia.

Abstract

Aim: This integrative review aimed to identify and describe oral changes resulting from HSCT, as well as evaluate the importance of dental care in the face of these complications. Methodology: An integrative literature review was carried out with bibliographic research of scientific articles in the electronic databases PubMed, Scielo and Biblioteca Virtual em Saúde (BVS) between the years 2009 and 2023. The following descriptors were used for the search: “hematopoietic stem cell transplantation”, “oral manifestations”, “mucositis”, “xerostomia” “dental care”, “dysgeusia”. Results: The main manifestations found were: oral mucositis, xerostomia, ulcerations, erythema, Graft Versus Host Disease (GVHD) and lichenoid lesions. Conclusion: Most patients undergoing HSCT have oral repercussions from the conditioning period to post-HSCT and such conditions affect the quality of life and survival of these patients, contributing to increased length of hospital stay. Therefore, the presence of a qualified dental surgeon at hospitals becomes necessary in the multidisciplinary team, in order to contribute to a significant increase in the patients’ quality of life.

References

Alhussain, A., Alkhayal, Z., Ayas, M., & Abed, H. (2022). Prevalence and risk factors of oral mucositis in paediatric patients undergoing haematopoietic stem cell transplantation. Oral diseases, 28(3), 657–669. https://doi.org/10.1111/odi.13777

de Araújo, R. L., Lyko, K.deF., Funke, V. A., & Torres-Pereira, C. C. (2014). Oral cancer after prolonged immunosuppression for multiorgan chronic graft-versus-host disease. Revista brasileira de hematologia e hemoterapia, 36(1), 65–68. https://doi.org/10.5581/1516-8484.20140016

Barrach, R. H., Souza, M. P., Silva, D. P., Lopez, P. S., & Montovani, J. C. (2015). Oral changes in individuals undergoing hematopoietic stem cell transplantation. Brazilian journal of otorhinolaryngology, 81(2), 141–147. https://doi.org/10.1016/j.bjorl.2014.04.004

Bulthuis, M. S., van Gennip, L. L. A., Bronkhorst, E. M., Blijlevens, N. M. A., Huysmans, M. D. N. J. M., van Leeuwen, S. J. M., & Thomas, R. Z. (2023). The effect of hematopoietic stem cell transplantation on patient-reported subjective oral dryness: a systematic review focusing on prevalence, severity and distress. Supportive care in cancer, 31(8), 449. https://doi.org/10.1007/s00520-023-07921-1

Bulthuis, M. S., van Gennip, L. L. A., Thomas, R. Z., Bronkhorst, E. M., Laheij, A. M. G. A., Raber-Durlacher, J. E., Rozema, F. R., Brennan, M. T., von Bültzingslöwen, I., Blijlevens, N. M. A., van Leeuwen, S. J. M., & Huysmans, M. D. N. J. M. (2022). Caries Progression after Haematopoietic Stem Cell Transplantation and the Role of Hyposalivation. Caries research, 56(3), 187–196. https://doi.org/10.1159/000525599

Bogusławska-Kapała, A., Kochańska, B., Rusyan, E., Basak, G. W., & Strużycka, I. (2021). Late Post-Operative Occurrence of Dentin Hypersensitivity in Adult Patients Following Allogeneic Hematopoietic Stem Cell Transplantation-A Preliminary Report. International journal of environmental research and public health, 18(16), 8761. https://doi.org/10.3390/ijerph18168761

Cantile, T., Coppola, N., Canfora, F., Adamo, D., Ruoppo, E., Mignogna, M. D., & Leuci, S. (2022). Oral Cancer in HSCT Pediatric Patients Arising on GVHD: A Comprehensive Review. Cancers, 14(23), 5775. https://doi.org/10.3390/cancers14235775

Chaudhry, H. M., Bruce, A. J., Wolf, R. C., Litzow, M. R., Hogan, W. J., Patnaik, M. S., Kremers, W. K., Phillips, G. L., & Hashmi, S. K. (2016). The Incidence and Severity of Oral Mucositis among Allogeneic Hematopoietic Stem Cell Transplantation Patients: A Systematic Review. Biology of blood and marrow transplantation, 22(4), 605–616. https://doi.org/10.1016/j.bbmt.2015.09.014

Doss, L. M., Dandoy, C. E., Kramer, K., Pate, A., Flesch, L., El-Bietar, J., Lane, A., Davies, S. M., & Thikkurissy, S. (2018). Oral health and hematopoietic stem cell transplantation: A longitudinal evaluation of the first 28 days. Pediatric blood & cancer, 65(1), 10.1002/pbc.26773. https://doi.org/10.1002/pbc.26773

Einstein. (2017). Transplante de células-tronco hematopoiéticas (TCTH). https://www.einstein.br/especialidades/hematologia/exames-tratamentos/tmo

Elad, S., Aljitawi, O., & Zadik, Y. (2021). Oral Graft-Versus-Host Disease: A Pictorial Review and a Guide for Dental Practitioners. International dental journal, 71(1), 9–20. https://doi.org/10.1111/idj.12584

Epstein, J. B., Raber-Durlacher, J. E., Wilkins, A., Chavarria, M. G., & Myint, H. (2009). Advances in hematologic stem cell transplant: an update for oral health care providers. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, 107(3), 301–312. https://doi.org/10.1016/j.tripleo.2008.12.006

Gomes, A. O., Torres, S. R., Maiolino, A., Dos Santos, C. W., Silva Junior, A., Correa, M. E., Moreira, M. C., & Gonçalves, L.deS. (2014). Early and late oral features of chronic graft-versus-host disease. Revista brasileira de hematologia e hemoterapia, 36(1), 43–49. https://doi.org/10.5581/1516-8484.20140012

Hernández-Fernández, A., Oñate-Sánchez, R. E., Cabrerizo-Merino, M. C., de Arriba-de la-Fuente, F., Heras-Fernando, I., & Vicente-García, V. (2012). Influence of oral health on mucositis in patients undergoing hematopoietic progenitor cell transplantation (HPCT). Medicina oral, patologia oral y cirugia bucal, 17(1), e94–e101. https://doi.org/10.4317/medoral.16997

Haverman, T. M., Raber-Durlacher, J. E., Rademacher, W. M., Vokurka, S., Epstein, J. B., Huisman, C., Hazenberg, M. D., de Soet, J. J., de Lange, J., & Rozema, F. R. (2014). Oral complications in hematopoietic stem cell recipients: the role of inflammation. Mediators of inflammation, 2014, 378281. https://doi.org/10.1155/2014/378281

Johnson, L. B., Oh, U., Rothen, M., Sroussi, H. Y., Dean, D. R., Lloid, C. M., Cintron, K., Lee, S. J., Cutler, C. S., & Treister, N. S. (2022). A Review of Oral Chronic Graft-Versus-Host Disease: Considerations for dental hygiene practice. Journal of dental hygiene, 96(2), 6–17.

Lima, E. das N. de A., Fernandes, M. Z., Ferreira, M. Â. F., Nonaka, C. F. W., Freitas, R. de A., & Medeiros, A. M. C. de .. (2012). Bone marrow transplantation: graft versus host disease and oral changes. Revista Odonto Ciência, 27(1), 10–15. https://doi.org/10.1590/S1980-65232012000100002

Luiz, A. C. (2015). Alterações bucais em pacientes submetidos ao transplante de células tronco hematopoiéticas: estudo longitudinal. [Tese de Doutorado, Universidade de Sao Paulo, USP]. Agencia USP de Gestao da Informacao Academica (AGUIA).

Maturo, P., Condò, R., Costacurta, M., & Docimo, R. (2009). Oral manifestations in the Graft versus Host Disease in paediatric patients: case report. Oral & implantology, 2(2), 34–41.

Mays, J. W., Fassil, H., Edwards, D. A., Pavletic, S. Z., & Bassim, C. W. (2013). Oral chronic graft-versus-host disease: current pathogenesis, therapy, and research. Oral diseases, 19(4), 327–346. https://doi.org/10.1111/odi.12028

Mendes, K. D. S., Silveira, R. C. de C. P., & Galvão, C. M. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & contexto enfermagem, 17(4), 758–764. https://doi.org/10.1590/s0104-07072008000400018

Mester, A., Irimie, A., Oprita, L., Dima, D., Petrushev, B., Lucaciu, O., Campian, R. S., & Tanase, A. (2018). Oral manifestations in stem cell transplantation for acute myeloid leukemia. Medical hypotheses, 121, 191–194. https://doi.org/10.1016/j.mehy.2018.06.015

Margaix-Muñoz, M., Bagán, J. V., Jiménez, Y., Sarrión, M. G., & Poveda-Roda, R. (2015). Graft-versus-host disease affecting oral cavity. A review. Journal of clinical and experimental dentistry, 7(1), e138–e145. https://doi.org/10.4317/jced.51975

Nappalli, D., & Lingappa, A. (2015). Oral manifestations in transplant patients. Dental research journal, 12(3), 199–208.

Passeri, L. A., Bértolo, M. B., & Abuabara, A. (2011). Osteonecrose dos maxilares associada ao uso de bisfosfonatos. Revista Brasileira De Reumatologia, 51(4), 404–407.

Paulo, S., Abrantes, A. M., Laranjo, M., Carvalho, L., Serra, A., Botelho, M. F., & Ferreira, M. M. (2014). Bisphosphonate-related osteonecrosis of the jaw: specificities. Oncology reviews, 8(2), 254. https://doi.org/10.4081/oncol.2014.254

Petti, S., Polimeni, A., Berloco, P. B., & Scully, C. (2013). Orofacial diseases in solid organ and hematopoietic stem cell transplant recipients. Oral diseases, 19(1), 18–36. https://doi.org/10.1111/j.1601-0825.2012.01925.x

Ruggiero, S. L., Dodson, T. B., Aghaloo, T., Carlson, E. R., Ward, B. B., & Kademani, D. (2022). American Association of Oral and Maxillofacial Surgeons' Position Paper on Medication-Related Osteonecrosis of the Jaws-2022 Update. Journal of oral and maxillofacial surgery, 80(5), 920–943. https://doi.org/10.1016/j.joms.2022.02.008

Santos, P. S. D. S., Granzotto, F. C. N., Antunes, H. S., de Lima, E. M., Varanda, R. F., Maccari, K., Bezinelli, L. M., Melo, W. R., Junior, L. A. V. S., De Macedo, L. D., & Eduardo, F. P. (2023). Dentistry consensus on HSCT - Part III: Special topics - Dentistry on HSCT. Hematology, transfusion and cell therapy, 45(3), 379–386. https://doi.org/10.1016/j.htct.2023.04.004

Scaraficci, A. C., Fernandes, P. M., Abreu Alves, F., Filho, J. S., & Jaguar, G. C. (2022). Oral manifestations of graft-versus-host disease in patients submitted to allogeneic hematopoietic stem cell transplantation: the experience of a Brazilian Cancer Center. Supportive care in cancer, 30(1), 567–573. https://doi.org/10.1007/s00520-021-06349-9

Scordo, M., Shah, G. L., Peled, J. U., Preston, E. V., Buchan, M. L., Epstein, J. B., Barasch, A., & Giralt, S. A. (2018). Unlocking the Complex Flavors of Dysgeusia after Hematopoietic Cell Transplantation. Biology of blood and marrow transplantation, 24(3), 425–432. https://doi.org/10.1016/j.bbmt.2017.10.022

Silva, T. D. B. (2017). Avaliação da mucosa oral dos pacientes submetidos ao transplante de células tronco hematopoiéticas na vigilância de risco de neoplasias secundárias. [Dissertação de Mestrado, Instituto Nacional de Câncer José Alencar Gomes da Silva, INCA].

Souza, M. T., Silva, M. D. & Carvalho, R. (2010). Integrative review: what is it? How to do it?. Einstein.8(1):102–6. https://doi.org/10.1590/S1679-45082010RW1134

Yarom, N., Shapiro, C. L., Peterson, D. E., Van Poznak, C. H., Bohlke, K., Ruggiero, S. L., Migliorati, C. A., Khan, A., Morrison, A., Anderson, H., Murphy, B. A., Alston-Johnson, D., Mendes, R. A., Beadle, B. M., Jensen, S. B., & Saunders, D. P. (2019). Medication-Related Osteonecrosis of the Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline. Journal of clinical oncology, 37(25), 2270–2290. https://doi.org/10.1200/JCO.19.01186

Published

07/11/2023

How to Cite

FERREIRA, F. D. da S. .; PEREIRA, E. S. .; FLORENTINO, F. A. A. .; MAGALHÃES, J. M. I. . Oral repercussions in patients undergoing hematopoietic stem cell transplantations: An integrative review of the literature. Research, Society and Development, [S. l.], v. 12, n. 11, p. e146121143882, 2023. DOI: 10.33448/rsd-v12i11.43882. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/43882. Acesso em: 17 nov. 2024.

Issue

Section

Health Sciences