Symbolic representation of healthy to dysplastic transformation in a tree, symbolizing oral health after stem cell transplant.

Oral Dysplasia After Stem Cell Transplants: What You Need to Know

Theo Raines in Health & Wellness November 2025 • 4 min read.

"A closer look at HPV-related oral dysplasia in multiple myeloma patients following stem cell transplantation."

Stem cell transplants offer hope for many battling hematological malignancies, yet they can also bring long-term complications. One such concern is the development of dysplastic changes in oral epithelial lesions. These changes, while not always cancerous, require vigilant monitoring and understanding.

A recent case highlights the potential link between stem cell transplantation, chronic graft-versus-host disease (cGVHD), and HPV-related oral dysplasia. The case involves a 54-year-old male with multiple myeloma who, after undergoing both autologous and allogenic HSCT, developed cGVHD and subsequent oral dysplasia.

This article explores the details of this case, shedding light on the risk factors, the role of HPV, and the importance of clinical follow-ups for individuals who have undergone stem cell transplantation.

Unpacking the Link: Stem Cell Transplants and Oral Dysplasia

Symbolic representation of healthy to dysplastic transformation in a tree, symbolizing oral health after stem cell transplant.

Multiple myeloma (MM) is a cancer of plasma cells in the bone marrow. Allogeneic hematopoietic stem cell transplant (HSCT) is a treatment option that gives patients a chance at long-term survival. However, oral complications are common after HSCT. Chronic graft-versus-host disease (cGVHD) is often seen with symptoms like lichenoid inflammation, hyperkeratotic reticulations, and ulcerations.

The case study highlights a 54-year-old male who, after undergoing HSCT, developed cGVHD affecting his mouth, skin, and eyes. He presented with diffuse white lesions on his buccal mucosa, tongue, and palate. A biopsy revealed moderate to severe epithelial dysplasia with hyperkeratosis, and tested positive for p16INK4A, indicating the presence of human papillomavirus (HPV).

Radiation and Chemotherapy Regimens: The intensity of these treatments can weaken the immune system.
Chronic Graft-versus-Host Disease (cGVHD): This condition, where the transplanted cells attack the host's tissues, can cause inflammation and damage in the oral cavity.
Inflammation: Chronic inflammation can create an environment conducive to dysplasia.
Prolonged Immunosuppression: Transplant recipients often require immunosuppressant drugs to prevent rejection, further weakening their defenses against infections like HPV.

The presence of HPV is a significant factor in this case. Certain types of HPV are known to cause dysplastic changes, which are abnormal cell growths that can potentially lead to cancer. Immunosuppression can increase the risk of HPV infection or reactivation, making transplant recipients more vulnerable.

Staying Proactive: What This Means for You

If you've undergone a stem cell transplant, particularly for multiple myeloma, it's essential to be proactive about your oral health. Regular dental check-ups are crucial for early detection of any abnormalities. Discuss any changes in your mouth with your dentist or oncologist. Early detection and intervention are key to managing oral dysplasia and preventing potential complications.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/scd.12344, Alternate LINK

Title: Hpv-Related Oral Dysplasia In A Multiple Myeloma Patient After Stem Cell Transplantation

Subject: General Dentistry

Journal: Special Care in Dentistry

Publisher: Wiley

Authors: Wafaa Saleh, Seunghee Cha, Bhattacharyya Indraneel, Jan Moreb, Joseph Katz

Published: 2018-11-15

Everything You Need To Know

What is the connection between stem cell transplants and oral dysplasia, especially for multiple myeloma patients?

Stem cell transplants, particularly allogeneic hematopoietic stem cell transplants (HSCT), used as a treatment for multiple myeloma, can lead to oral complications such as oral dysplasia. Chronic graft-versus-host disease (cGVHD), a common sequel to HSCT, causes inflammation and damage in the oral cavity, creating an environment where dysplastic changes in oral epithelial lesions can develop. These changes, while not always cancerous, necessitate careful monitoring. The presence of human papillomavirus (HPV) can exacerbate this risk due to immunosuppression following the transplant.

How does HPV play a role in oral dysplasia after a stem cell transplant?

Human papillomavirus (HPV) is a significant factor in oral dysplasia following a stem cell transplant. Certain types of HPV are known to cause dysplastic changes, which are abnormal cell growths that can potentially lead to cancer. Immunosuppression, a consequence of transplant and necessary medications, increases the risk of HPV infection or reactivation, making transplant recipients more vulnerable to HPV-related oral dysplasia. The case study highlights how the detection of p16INK4A, a marker for HPV, is important in monitoring these patients.

What are the main risk factors that contribute to oral dysplasia in stem cell transplant recipients?

Several risk factors contribute to oral dysplasia in stem cell transplant recipients. These include the intensity of radiation and chemotherapy regimens, which weaken the immune system; chronic graft-versus-host disease (cGVHD), causing inflammation in the oral cavity; prolonged immunosuppression required to prevent transplant rejection; and the presence of human papillomavirus (HPV). These factors create an environment conducive to dysplasia, especially in individuals who have undergone allogeneic hematopoietic stem cell transplant (HSCT) for multiple myeloma.

What does chronic graft-versus-host disease (cGVHD) do in the context of stem cell transplants and oral health?

Chronic graft-versus-host disease (cGVHD) is a condition where transplanted cells attack the host's tissues, leading to inflammation and damage in various parts of the body, including the oral cavity. In the mouth, cGVHD can manifest as lichenoid inflammation, hyperkeratotic reticulations, and ulcerations. This chronic inflammation creates an environment that increases the risk of developing oral dysplasia, especially in patients who have undergone allogeneic hematopoietic stem cell transplant (HSCT).

What proactive steps can individuals who have undergone a stem cell transplant take to monitor and prevent oral dysplasia?

Individuals who have undergone a stem cell transplant, particularly for multiple myeloma, should prioritize proactive oral health measures. Regular dental check-ups are crucial for the early detection of any abnormalities. Any changes in the mouth should be promptly discussed with a dentist or oncologist. Early detection and intervention are key to managing oral dysplasia and preventing potential complications. Since prolonged immunosuppression increases the risk of human papillomavirus (HPV) related issues, regular screenings may be beneficial.