Association of cyclophosphamide use with dental developmental defects and salivary gland dysfunction in recipients of childhood antineoplastic therapy

Abstract

BACKGROUND:The aim of this study was to examine the effect of antineoplastic therapy on dental development and saliva function in recipients of childhood antineoplastic therapy. METHODS: Patients attending the long-term follow-up clinic at Children's Hospital at Westmead, NSW, Australia, were included if they had received treatment prior to 16 years of age and were in remission for more than 5 years. A dental examination and saliva test were performed for each participant. Holtta's Defect Index (HDI) was used to assess tooth aplasia, microdontia, and root-crown ratio on an orthopantomogram (OPG). Multivariable-adjusted regression analyses were used to estimate the association of patient characteristics and treatment modalities with dental outcomes. RESULTS: One hundred six participants (61% male) were recruited (response rate ¼ 88%). The mean HDI score was 24.7 AE 17.8. A cumulative dose of cyclophosphamide >7500 mg/m 2 increased the HDI score by 13.06 (P ¼ .01). Recipients of cyclophosphamide also had significantly increased odds of exhibiting very low saliva flow (<0.7 mL/min) (odds ratio ¼ 12.43; 95% confidence interval, 2.08-74.35; P ¼ .006). CONCLUSIONS: Children and adolescents who received high doses of cyclophosphamide were at increased risk of dental disturbances. Cyclophosphamide recipients were also at greater risk of exhibiting very low saliva flow. This study applied the HDI to patients receiving all forms of antineoplastic treatment and highlights the dose-dependent relation between cumulative dose of cyclophosphamide and dental disturbances.

SCID patients with ARTEMIS vs RAG deficiencies following HCT: increased risk of late toxicity in ARTEMIS-deficient SCID

“…by guest www.bloodjournal.org From reported in pediatric recipients of alkylating therapy for neoplasias and in patients treated with radiotherapy. 25,26 Young age at the time of treatment appeared as an additional risk factor. In the present analysis, these abnormalities were only documented in SCID patients due to ARTEMIS, but not RAG1/2 deficiencies.…”

Cyclophosphamide Administration Routine in Autoimmune Rheumatic Diseases: A Review

“…Cyclophosphamide is also teratogenic. 21 A long term reaction of cyclophosphamide is malignacies. 18 One can observe an increase in the incidence of bladder cancer and esophageal and lung adenocarcionoma, which customarily occur after two years of treatment.…”

Effects of oncological treatment on tooth development in children with brain tumors: Description of cases

“…15 Earlier experimental studies on rat teeth showed that wide cell-free areas, which later turned into osteodentin, appeared in the third molar of animals after injections of cyclophosphamide at the dose of 30 mg per kg of body weight. The injections were made on the 10 th and 13 th day of age and the sites affected by changes were related to the developmental stage of tooth germ.…”

“…Hsieh et al found that half of the recipients of childhood antineoplastic therapy had low (0.7-1.0 mL/min) or very low (< 0.7 mL/min) saliva flow. 15 On the other hand, authors indicated that a higher incidence of caries in cancer survivors was often related to the lack of proper caries prophylaxis during and after treating the main disease. 10 Cancer patients, who were included in proper dental care programs, did not differ in terms of caries scores from their healthy peers.…”