Objective: Malignant haematological diseases are more common and increasingly occur in young populations. Early detection of the manifestations of these syndromes in the oral cavity may enable early diagnosis and more efficient treatment. The treatment of these diseases is intensive cytostatic, with the most efficient being autologous and allogeneic haemopoietic stem cell transplantation (HSCT). The conditioning treatment used is an outstanding form of high-dose chemotherapy. Total body irradiation is applied routinely with allogeneic HSCT while with autologousus HSCT, it is used following proper indication, accounting for 12-15 Gy doses in 3 or 4 days. Oral mucositis, the resulting serious immunosuppresion, significantly increases the disease’s morbidity. With myeloma multiplex transplant patients we also need to consider the effects of long-term intravenous bisphosphonates treatment on the mucosa and the difficulties of the removal of focal infection.
Method: 45 autologous HSCT patients (ages 17-69) were followed from the day of the transplantation for an average of 15 days, over a period of 1 year. All changes in the oral cavity were recorded on decursing sheets, accompanied by photo documentation. The relationship between the occurring changes and the laboratory parameters were recorded as was the patients’ oral hygiene status.
Result: Neglected oral hygiene (66% of patients) accounted for more frequent stages 1, 2, and 3 of oral mucositis together with dry mouth and more frequent need for parenteral nutrition. Eradication of focal infection decreased the likelihood of oral mucositis.
Conclusion: Damage to the protective mucosal barrier not leads to a considerable decrease in quality of life and concomitant bacteraemia may cause fatal sepsis. Hence, before autologous or allogeneic HSCT, complex dental focal infection exploration and removal of the focal infection are necessary.