Oral adverse events and the risk factors in hematopoietic stem cell transplant recipients: A retrospective study

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K18684
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 57060:Surgical dentistry-related
• Research Institution: National Center for Global Health and Medicine
• Principal Investigator: Shimada Yasuyuki 国立研究開発法人国立国際医療研究センター, その他部局等, 歯科口腔外科医師 (50751757)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 造血器腫瘍 / 造血幹細胞移植 / 口腔 / 有害事象 / リスク因子

Outline of Final Research Achievements

This study aims to assess OAEs that occurs following HSCT in the early phase and OAEs-related risk factors in patients undergoing HSCT. In addition, the effectiveness of tooth extraction as a method of radically removing dental focal infections (DFIs) prior to HSCT has been discussed, alongside a literature review.
From our study, HSCT recipients who have not undergone continuous oral care following HSCT or who have a long period of low ANC (<500/μL) following HSCT are more likely to occur OAEs, and the latter was also suggested that the higher risk of developing OAE-related sepsis. In addition, it is considered that tooth extraction as a removal of DFIs should be actively performed before HSCT after thoroughly discussing the necessity for it and its timing among dental surgeons and hematologists.

Free Research Field

口腔内科学

Academic Significance and Societal Importance of the Research Achievements

免疫力低下に伴い、齲蝕や歯周炎などの口腔内感染巣は敗血症など全身への有害事象として波及することがある。抗悪性腫瘍薬投与や造血幹細胞移植などにより経時的な骨髄抑制が懸念される造血器腫瘍（多発性骨髄腫、白血病、悪性リンパ腫など）を有する患者に対しては未然に口腔内のスクリーニングを行い、感染巣を根治的に除去するために必要に応じて抜歯術を行うことの有用性、そして造血幹細胞移植後も継続的に口腔内の評価を行うことの有用性を本研究で示すことができた。