# Periodontal changes after haematopoietic cell transplantation and the role of conditioning regimen intensity

## TL;DR

This study examines how periodontal health changes after hematopoietic cell transplantation and whether the intensity of the conditioning regimen affects these changes.

## Contribution

The study provides new insights into the relationship between conditioning regimen intensity and periodontal outcomes following allogeneic HCT.

## Key findings

- Periodontal health improved marginally in the short-term following HCT and supportive oral care.
- Differences in post-HCT periodontal health between patients conditioned with NMA, RIC, and MA were not clinically relevant.

## Abstract

To evaluate periodontal health after allogeneic haematopoietic cell transplantation (HCT), and its association with conditioning regimen intensity.

This single-centre retrospective cohort study included 82 allogeneic HCT recipients between 01/08/2017 and 31/03/2022. Probing pocket depth (PPD), bleeding on probing (BOP), periodontal epithelial surface area (PESA) and periodontal inflamed surface area (PISA) were assessed pre- and post-HCT. Change scores were calculated, and regression models were applied to analyse associations with conditioning intensity. Conditioning regimens were categorised based on intensity as non-myeloablative (NMA), reduced intensity (RIC) or myeloablative (MA).

HCT recipients had a median age of 59 years (IQR 48–66); 63% were male. Median time to HCT was 53 days (IQR 29–89), median follow-up was 279 days (IQR 183–349). Severe periodontitis (≥ 1 site with PPD ≥ 6 mm) was observed in 37% of patients pre-HCT and 20% of patients post-HCT. PPD, BOP, PESA and PISA decreased from pre- to post-HCT, by 0.26 mm [95%CI 0.16;0.37], 8% [95%CI 5;12], 140 mm2 [95%CI 89;190] and 123 mm2 [95%CI 83;185], respectively. Prevalence of severe periodontitis decreased from pre- to post-HCT in all groups: NMA 50% to 27%, RIC 32% to 19%, MA 31% to 13%. Conditioning intensity was statistically significantly associated with post-HCT PPD and PESA; however, differences were small. No statistically significant differences were observed in post-HCT PISA between conditioning regimens.

Periodontal health improved marginally in the short-term following HCT and supportive oral care. Differences in post-HCT periodontal health between patients conditioned with NMA, RIC, and MA were not clinically relevant.

The online version contains supplementary material available at 10.1007/s00520-025-09654-9.