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Oral Complications After Haematopoietic Stem Cell Transplantation: a Retrospective Study

Conditions
Oral Complication
Stem Cell Transplant Complications
Registration Number
NCT05595070
Lead Sponsor
Radboud University Medical Center
Brief Summary

Haematopoietic stem cell transplantation (HSCT) is a potentially lifesaving treatment option for various diseases. It involves infusion of stem cells after a conditioning regimen of chemotherapy with or without total body irradiation. There is a concern that HSCT and accompanying treatments may increase the risk for oral complications. Nevertheless, longitudinal studies measuring oral health before and after HSCT are scarce. Hence, we formulated the following research question:

In adult HSCT recipients, do oral health parameters change from baseline (pre-HSCT) to 3 - 24 months post-HSCT, and is the type of conditioning regimen associated with this change in oral health parameters?

To answer this research question, we will use data from the electronic health records of the Radboudumc (Epic and Dentium). We will include at least seventy-five adult patients who are examined both before and after HSCT at the department of Dentistry (Radboudumc) as part of an oral care program. The following oral health parameters were assessed: status praesens, pocket probing depth, bleeding on probing, periodontal epithelial surface area, periodontal inflamed surface area, xerostomia, unstimulated and stimulated salivary flow rate and pH, cariesactivity, oral chronic Graft-versus-Host Disease and dental treatments.

Patients were subjected to different regimens in preparation for HSCT, namely myeloablative, reduced intensity or non-myeloablative conditioning. To estimate the association between conditioning regimen and the change in oral health parameters, we will use mixed effects models with random effects, adjusted for potential confounders. Results will be reported as regression coefficients with corresponding 95% confidence intervals.

Detailed Description

Not available

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Allogeneic HSCT between 2013 and 2021 at Radboudumc
  • Oral focal screening before HSCT, and at least one oral examination after HSCT performed at Department of Dentistry, Radboudumc
  • Informed consent
Exclusion Criteria
  • Not meeting the inclusion criteria

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Unstimulated and chewing stimulated salivary pHChange from baseline (pre-HSCT) up to 24 months after HSCT

Whole mouth saliva, measured with pH strips

Pocket probing depthChange from baseline (pre-HSCT) up to 24 months after HSCT

Pocket probing depth at 6 sites per tooth in millimetres

Number of restorationsChange from baseline (pre-HSCT) up to 24 months after HSCT

Total number of restored tooth surfaces

Bleeding on probingChange from baseline (pre-HSCT) up to 24 months after HSCT

Profound bleeding on probing at 6 sites per tooth as yes or no

Number of teethChange from baseline (pre-HSCT) up to 24 months after HSCT

Number of teeth (range 0 - 32)

Unstimulated and chewing stimulated salivary flow rateChange from baseline (pre-HSCT) up to 24 months after HSCT

Whole mouth saliva, measured in mL/min

Secondary Outcome Measures
NameTimeMethod
Periodontal Epithelial Surface AreaChange from baseline (pre-HSCT) up to 24 months after HSCT

The root surface area in square millimetres affected by attachment loss

Oral chronic Graft-versus-Host DiseaseUp to 24 months after HSCT

Assessed with National Institute of Health Oral Mucosal Score (range 0 - 15), higher score means more severe oral manifestations of oral chronic Graft-versus-Host Disease

Periodontal Inflamed Surface AreaChange from baseline (pre-HSCT) up to 24 months after HSCT

The root surface area in square millimetres affected by attachment loss and inflamed periodontal tissue

CariesactivityUp to 24 months after HSCT

Likelihood for development of new caries lesions based on notes recorded by the dentist

ExtractionsBetween baseline (pre-HSCT) and up to 24 months after HSCT

Total number of removed teeth (range 0 - 32)

Periodontal careBetween baseline (pre-HSCT) and up to 24 months after HSCT

Number of participants per type of periodontal care, categorised in sub- and supragingival cleaning, subgingival cleaning, no cleaning

XerostomiaChange from baseline (pre-HSCT) up to 24 months after HSCT

Subjective oral dryness measured by Xerostomia Inventory questionnaire

Preventive measuresBetween baseline (pre-HSCT) and up to 24 months after HSCT

Number of participants per type of preventive measure as fluoride varnish and oral hygiene instructions

Trial Locations

Locations (1)

Radboudumc

🇳🇱

Nijmegen, Netherlands

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