RESEARCH PAPER ANALYSIS
Comparison of late dental sequelae in survivors of high-risk neuroblastoma treated with myeloablative high-dose chemotherapy and peripheral blood stem cell transplantation.
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OBJECTIVES: Dental defects were evaluated in high-risk neuroblastoma survivors (HRNBLs) who underwent myeloablative conditioning with 1 of 2 high-dose chemotherapy (HDC) regimens prior to autologous peripheral blood stem cell transplantation (PBSCT), without exposure to total body irradiation. The regimens compared were busulfan/melphalan (BuMel) and carboplatin/etoposide/melphalan (CEM). STUDY DESIGN: Clinical records from 2019-2022 of HRNBL survivors at the Children's Hospital at Westmead were reviewed. Dental defects were assessed using orthopantomograms and quantified using Holtta's defect index (HDI). RESULTS: Thirteen BuMLP and thirteen CEM patients were included. Mean age at HDC was 3.0 ± 1.1 years and mean age at assessment was 11.3 ± 3.2 years. The study population presented with a mean HDI of 45.6 (±18.8). BuMLP presented with a mean HDI of 51.9 (±18.8) compared to CEM with a mean HDI of 39.4 (±17.3), although this was not statistically significant. All subjects demonstrated altered root development (P = .04), while 65.4% (n = 17) presented with microdontia and 69.2% (n = 18) exhibited dental agenesis. CONCLUSION: HRNBLs show a high prevalence of dental defects after HDC. Impacts of BuMLP versus CEM require further investigation.
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