Oral health risks associated with HLA-types of patients undergoing hematopoietic stem cell transplantation


PD Dr Tuomas Waltimo, Universitätskliniken für Zahnmedizin, Hebelstrasse 3, CH-4056 Basel, Switzerland. Tel: +41 61 267 26 03; Fax: +41 61 267 26 58; e-mail: tuomas.waltimo@unibas.ch


Aim:  Dental caries, gingivitis and periodontitis are frequent long-term complications after hematopoietic stem cell transplantation (HSCT). Not all patients are affected equally. As HLA-genotypes are associated with many functions of the immune system we made use of our long-standing oral health program in HSCT recipients to compare oral health data with recipient HLA-antigens.

Patients and methods:  This study includes 267 patients evaluated prior to a planned HSCT at our institution between March 1987 and March 2002. Standardized oral examinations were undertaken at fixed time points: pre-HSCT and at 6 and 12 months post-HSCT. Evaluation included loss of radiologic attachment level, decayed, missing, filled teeth (DMFT) index, and salivary flow rate. For 241 patients (120 males, 121 females) baseline values of these parameters were compared with recipient HLA-A, -B, -C and -DR-antigens.

Results:  Significant correlations were found between increased DMFT and HLA-A32 (P = 0.05), -B5 (0.04), and -DR2 (0.05) as well as decreased DMFT with HLA-B35 (0.02) and -C4 (0.04). Significant associations were also found between certain HLA-antigens and loss of radiologic periodontal attachment level [HLA-A1 (<0.01), -C7 (0.04), and -B60 (0.05)], and saliva flow rate [HLA-A30 (0.02)].

Conclusions:  These data suggest that there may be associations between pretransplant caries, other oral parameters and HLA in patients at HSCT. Confirmatory studies concerning the associations of certain HLA-antigens with caries and periodontal diseases will be needed.