Top

Published in:

01-09-2009 | Original Article

Long-term adverse effects of hematopoietic stem cell transplantation on dental development in children

Authors: I. G. M. van der Pas-van Voskuilen, J. S. J. Veerkamp, J. E. Raber-Durlacher, D. Bresters, A. J. van Wijk, A. Barasch, S. McNeal, R. A. Th. Gortzak

Published in: Supportive Care in Cancer | Issue 9/2009

Abstract

Purpose

The purpose of this study was to assess late effects of cytotoxic therapy with hematopoietic stem cell transplantation (HCT) on dental development in survivors of childhood cancer.

Materials and methods

Forty children who underwent allogeneic HCT for a variety of hematological malignancies were evaluated at a minimum of 2 years after transplantation. We obtained information on oral symptoms, exposed panoramic radiographs (PRG), and performed an oral examination. PRGs were scored for agenesis and root and/or crown abnormalities. The root–crown ratio was calculated, and dental age was assessed using Demirjian’ s method.

Main results

The studied group showed a significantly higher prevalence of tooth agenesis compared to normative data for first and second premolars in both the maxilla and mandible, as well as the second molars in the mandible (all p values <0.001). Children who were <3 years old at the time of cancer treatment had significantly more missing teeth than older children, F(2,37) = 7.58, p < 0.002. Root–crown ratios were lower in the study sample than those from normative data. In addition, the mean dental age was higher (as a result of earlier apical root closure) than the mean chronological age, t(28) = 2.47, p < 0.020.

Conclusions

Nearly all children examined had dental development disturbances, including agenesis, short roots, and arrested root development. An oral/dental evaluation and preventative oral supportive care regimens should be part of programs monitoring late effects in long-term survivors of childhood cancer.

Avşar A, Elli M, Darka Ö, Pinarli G (2007) Long term effects of chemotherapy on caries formation, dental development, and salivary factors in childhood cancer survivors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104:781–789 doi:10.1016/j.tripleo.2007.02.029 PubMedCrossRef

Bågesund M, Richter S, Ringdén O, Dahllöf G (2007) Longitudinal scintigraphic study of parotid and submandibular gland function after total body irradiation in children and adolescents. Int J Paediatr Dent 17:34–40 doi:10.1111/j.1365-263X.2006.00786.x PubMedCrossRef

Bågesund M, Winiarski J, Dahllöf G (2000) Subjective xerostomia in long-term surviving children and adolescents after pediatric bone marrow transplantation. Transplantation 69:822–826 doi:10.1097/00007890-200003150-00026 PubMedCrossRef

Bhatia S, Francisco L, Carter A, Sun CL, Baker KS, Gurney JG, McGlave PB, Nademanee A, O’Donnell M, Ramsay NK, Robison LL, Snyder D, Stein A, Forman SJ, Weisdorf DJ (2007) Late mortality after allogeneic hematopoietic cell transplantation and functional status of long-term survivors: report from the Bone Marrow Transplant Survivor Study. Blood 110:3784–3792 doi:10.1182/blood-2007-03-082933 PubMedCrossRef

Curtis RE, Rowlings PA, Deeg HJ, Shriner DA, Socie G, Travis LB, Horowitz MM, Witherspoon RP, Hoover RN, Sobocinski KA, Fraumeni JF Jr, Boice JD Jr (1997) Solid cancers after bone marrow transplantation. N Engl J Med 336:897–904 doi:10.1056/NEJM199703273361301 PubMedCrossRef

Dahllöf G (1998) Craniofacial growth in children treated for malignant diseases. Acta Odontol Scand 56:378–382 doi:10.1080/000163598428365 PubMedCrossRef

Dahllöf G, Bågesund M, Remberger M, Ringdén O (1997) Risk factors for salivary dysfunction in children 1 year after bone marrow transplantation. Oral Oncol 33:327–331PubMedCrossRef

Dahllöf G, Bågesund M, Ringdén O (1997) Impact of conditioning regimens on salivary function, caries-associated microorganisms and dental caries in children after bone marrow transplantation. A 4-year longitudinal study. Bone Marrow Transplant 20:479–483 doi:10.1038/sj.bmt.1700919 PubMedCrossRef

Demirjian A, Goldstein H, Tanner JM (1973) A new system of dental age assessment. Hum Biol 45:211–227PubMed

10.

Dens F, Boogaerts M, Boute P, Boute P, Declerck D, Demuynck H, Vinckier F (1996) Quantitative determination of immunological components of salivary gland secretion in transplant recipients. Bone Marrow Transplant 17:421–423PubMed

11.

Dugal MS (2003) Root surface areas in long-term survivors of childhood cancer. Oral Oncol 39:178–183 doi:10.1016/S1368-8375(02)00089-1 CrossRef

12.

Ferry C, Gemayel G, Rocha V, Labopin M, Esperou H, Robin M, de Latour RP, Leblanc T, Gluckman E, Baruchel A, Socié G (2007) Long-term outcomes after allogeneic stem cell transplantation for children with hematological malignancies. Bone Marrow Transplant 40:219–224 doi:10.1038/sj.bmt.1705710 PubMedCrossRef

13.

Forsberg CM, Krekmanova L, Dahllöf G (2002) The effect of growth hormone therapy on mandibular and cranial base development in children treated with total body irradiation. Eur J Orthod 24:285–292 doi:10.1093/ejo/24.3.285 PubMedCrossRef

14.

Geenen MM, Cardous-Ubbink MC, Kremer LC, van den Bos C, van der Pal Hj, Heinen RC, Jaspers MW, Koning CC, Oldenburger F, Langeveld NE, Hart AA, Bakker PJ, Caron HN, van Leeuwen FE (2007) Medical assessment of adverse health outcomes in long-term survivors of childhood cancer. JAMA 297:2705–2715 doi:10.1001/jama.297.24.2705 PubMedCrossRef

15.

Höltta P, Nyström P, Evälahti M, Alaluusa S (2004) Root–crown ratios of permanent teeth in a healthy Finnish population assessed from panoramic radiographs. Eur J Orthod 26:491–497 doi:10.1093/ejo/26.5.491 PubMedCrossRef

16.

Höltta P, Alaluusua S, Saarinen-Pihkala UM, Wolf J, Nyström M, Hovi L (2002) Long-term adverse effects on dentition in children with poor-risk neuroblastoma treated with high-dose chemotherapy and autologous stem cell transplantation with or without total body irradiation. Bone Marrow Transplant 29:121–127 doi:10.1038/sj.bmt.1703330 PubMedCrossRef

17.

Höltta P, Alaluusua S, Saarinen-Pihkala UM, Peltola J, Hovi L (2005) Agenesis and microdontia of permanent teeth as late adverse effects after stem cell transplantation in young children. Cancer 103:181–190 doi:10.1002/cncr.20762 PubMedCrossRef

18.

Höltta P, Hovi L, Saarinen-Pihkala UM, Peltola J, Alaluusua S (2005) Disturbed root development of permanent teeth after pediatric stem cell transplantation. Cancer 103:1484–1493 doi:10.1002/cncr.20967 PubMedCrossRef

19.

Leahey AM, Teunissen H, Friedman DL, Moshang T, Lange BJ, Meadows AT (1999) Late effects of chemotherapy compared to bone marrow transplantation in the treatment of pediatric acute myeloid leukemia and myelodysplasia. Med Pediatr Oncol 32:163–169 doi:10.1002/(SICI)1096-911X(199903)32:3<163::AID-MPO1>3.0.CO;2-# PubMedCrossRef

20.

Leiper AD (2002) Non-endocrine late complications of bone marrow transplantation in childhood: part II. Br J Haematol 118:23–43 doi:10.1046/j.1365-2141.2002.03471.x PubMedCrossRef

21.

Leurs IH, Wattel E, Aartman IHA, Etty E, Prahl-Andersen B (2005) Dental age in Dutch children. Eur J Orthod 27:309–314 doi:10.1093/ejo/cji010 PubMedCrossRef

22.

Lopes NNF, Petrilli AS, Caran EMM, França CM, Chilvarquer I, Lederman H (2006) Dental abnormalities in children submitted to antineoplastic therapy. J Dent Child 73:140–145

23.

Lucas VS, Roberts GJ, Beighton D (1998) Oral health of children undergoing allogeneic bone marrow transplantation. Bone Marrow Transplant 22:801–808 doi:10.1038/sj.bmt.1701415 PubMedCrossRef

24.

Näsman M, Forsberg CM, Dahllöf G (1997) Long-term dental development in children after treatment for malignant disease. Eur J Orthod 19:151–159 doi:10.1093/ejo/19.2.151 PubMedCrossRef

25.

Nunn JH, Welbury RR, Gordon PH, Kernahan J, Craft AW (1991) Dental caries and dental anomalies in children treated by chemotherapy for malignant disease: a study in the north of England. Int J Paediatr Dent 1:131–135PubMedCrossRef

26.

Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, Friedman DL, Marina N, Hobbie W, Kadan Lottck NS, Schwartz CL, Leisenring W, Robison LL, Childhood Cancer Survivor Study (2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355:1572–1582 doi:10.1056/NEJMsa060185 PubMedCrossRef

27.

Oğuz A, Çetiner S, Karadeniz C, Alpaslan G, Alpaslan C, Pinarli G (2004) Long-term effects of chemotherapy on orodental structures in children with non-Hodgkin’s lymphoma. Eur J Oral Sci 112:8–11 doi:10.1111/j.0909-8836.2004.00094.x PubMedCrossRef

28.

Pajari U, Lanning M (1995) Developmental defects of teeth in childhood ALL are related to the therapy and age at diagnosis. Med Pediatr Oncol 24:310–314 doi:10.1002/mpo.2950240508 PubMedCrossRef

29.

Pajari U, Yliniemi R, Mottonen M (2001) The risk of caries in childhood cancer is not high if the teeth are caries-free at diagnosis. Pediatr Hematol Oncol 18:181–185 doi:10.1080/08880010151114787 PubMedCrossRef

30.

Polder BJ, Hof van ‘t MA, Linden van der FPGM, Kuijpers-Jagtman AM (2004) A meta-analysis of the prevalence of dental agenesis of permanent teeth. Community Dent Oral Epidemiol 32:217–226 doi:10.1111/j.1600-0528.2004.00158.x PubMedCrossRef

31.

Purdell-Lewis D, Stalman MS, Leeuw JA, Humphrey GB, Kalsbeek H (1988) Long term results of chemotherapy on the developing dentition: caries risk and developmental aspects. Community Dent Epidemiol 16:68–71 doi:10.1111/j.1600-0528.1988.tb01845.x CrossRef

32.

Rosenberg SW, Kolodney H, Wong GY, Murphy ML (1987) Altered dental root development in long-term survivors of pediatric acute lymphoblastic leukemia. Cancer 59:1640–1648 doi:10.1002/1097-0142(19870501)59:9<1640::AID-CNCR2820590920>3.0.CO;2-V PubMedCrossRef

33.

Sonis AL, Tarbell N, Valachovic RW, Gelber R, Schwenn M, Sallan S (1990) Dentofacial development in long-term survivors of acute lymphoblastic leukemia. A comparison of three treatment modalities. Cancer 12:2645–2652 doi:10.1002/1097-0142(19901215)66:12<2645::AID-CNCR2820661230>3.0.CO;2-S CrossRef

34.

Uderzo C, Fraschini D, Balduzzi A, Galimberti S, Arrigo C, Biagi E, Pignanelli M, Nicolini B, Rovelli A (1997) Long-term effects of bone marrow transplantation on dental status in children with leukaemia. Bone Marrow Transplant 20:865–886 doi:10.1038/sj.bmt.1700993 PubMedCrossRef

35.

Vaughan MD, Rowland CC, Tong X, Srivastava DK, Hale GA, Rochester R, Kaste SC (2005) Dental abnormalities after pediatric bone marrow transplantation. Bone Marrow Transplant 8:725–729 doi:10.1038/sj.bmt.1705136 CrossRef

36.

Wogelius P, Dahllöf G, Gorst-Rasmussen A, Sørensen HT, Rosthøj S, Poulsen S (2008) A population-based observational study of dental caries among survivors of childhood cancer. Pediatr Blood Cancer 50:1221–1226 doi:10.1002/pbc.21464 PubMedCrossRef

37.

Wijk van AJ, Tan SPK (2006) A numeric code for identifying patterns of human tooth agenesis: a new approach. Eur J Oral Sci 114:97–101 doi:10.1111/j.1600-0722.2006.00340.x PubMedCrossRef

Title: Long-term adverse effects of hematopoietic stem cell transplantation on dental development in children
Authors: I. G. M. van der Pas-van Voskuilen
J. S. J. Veerkamp
J. E. Raber-Durlacher
D. Bresters
A. J. van Wijk
A. Barasch
S. McNeal
R. A. Th. Gortzak
Publication date: 01-09-2009
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 9/2009
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-008-0567-1

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Main results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2009

Symptom clusters in patients with advanced cancers

The existential experiences of receiving soft tissue massage in palliative home care—an intervention

Effect of casopitant, a novel NK-1 antagonist, on the pharmacokinetics of dolasetron and granisetron

Understanding the cultural health belief model influencing health behaviors and health-related quality of life between Latina and Asian-American breast cancer survivors

Impact of casopitant, a novel NK-1 antagonist, on the pharmacokinetics of ondansetron and dexamethasone

Evaluation of intervention to prevent hypomagnesemia in cervical cancer patients receiving combination cisplatin and radiation treatment

Keynote webinar | Spotlight on antibody–drug conjugates in cancer