Karin Garming Legert

Karin Garming-Legert

Adjunkt/övertandläkare

Om mig

After completing the study program in nursing (1987) and the study program in dentistry (1993), I worked as a hospital dentist and clinical teacher at Karolinska Institutet with special interest in oral medicine. In 2019 I became a specialist in orofacial medicine. I undertook my PhD education at Karolinska Institutet and defended my thesis in 2011. The title was ​"Conditioning associated effects on oral mucosa and salivary secretion in allogeneic stem cell recipients", supervised by Professor Göran Dahllöf, Professor Anders Heimdahl and Professor Olle Ringdén. Since around 2000, I have been a lecturer at the Department of Dental Medicine and have since 2012 focused on oral medicine and clinical oral pathology education of dental, dental hygienist and continuing professional education dentists. In 2015, I was appointed as Program Director for the study programs in Dentistry and the Complementary Program for Dentists outside EU/EES and Switzerland. I have since then been heavily involved in the development and implementation of the new dental program study plan. Alongside my teaching and mentoring activities for the undergraduate education, I am supervisor for several students in the dental Specialist Training Program, as well as supervisor for PhD candidates. 

Forskningsbeskrivning

Current research focuses on developing pathological diagnostics and understanding disease processes in the soft tissues of the oral cavity. We are concerned with the complications that result following hematopoietic cell transplantation in the form of Graft versus Host Disease (GVHD). Oral manifestations are one of the most common and debilitating complications with the histopathology poorly understood, particularly associated with long-standing chronic (c)GVHD. Our ongoing studies are working to understand oral mucosal and salivary gland cGVHD pathogenesis, clinical and diagnostic criteria and the search for predictive biomarkers. 

Additional, studies are examining other debilitating chronic oral complications after high-dose chemotherapy and/ or stem cell transplantation, for example the necessity for transfusion of platelets before invasive dental procedures and the development of surgical techniques in patients treated with bisphosphonates.

We also aim to find out more about the pathogenesis and clinical pattern of different oral mucosal lesions as, white snuff induced oral lesions, aphthous stomatitis and oral manifestations in patients suffering from inflammatory bowel disease, where we strive to progress the management. Currently we are doing a screening study of the dental status in patients with X-linked hypophosphatemia.

 

Research group

Rachael Sugars (PI)

Karin Garming-Legert

Maria Bankvall

Victor Tollemar (Doctoral Student)

Helena Arvidsson (Doctoral Student)

Nikolce Tudzarovski

 

Original publications

  1. Efficacy of a novel device for cryoprevention of oral mucositis: a randomised, blinded, multicentre, parallel group, phase 3 trial. Java Walladbegi, Roger Henriksson, Björn Tavelin, Anncarin Svanberg, Gunnar Larfors, Martin Jädersten, Fredrik Schjesvold, Aram Mahdi, Karin Garming-Legert, Douglas E Peterson, Mats Jontell. Bone Marrow Transplant. 2022;57(2):191-197
  2. Karin Garming Legert, Olle Ringdén, Mats Remberger, Johan Törlén, Jonas Mattsson, Göran Dahllöf. Oral mucositis after tacrolimus/sirolimus or cyclosporine/methotrexate as graft-versus-host disease prophylaxis. Oral Dis. 2020 Oct 4. doi: 10.1111/odi.13663. Online ahead of print.
  3. Tollemar, V; Tudzarovski, N; Warfvinge, G; Yarom, N; Remberger, M; Heymann, R; Garming-Legert, K; Sugars, RV. Histopathological Grading of Oral Mucosal Chronic Graft-versus-host Diseease: Large Cohort Analysis. Biology of blood and marrow transplantation: journal of the American Sociaty for Blood and Marrow Transplantation. 2020; 26(10): 1971-1979
  4. Erik Boberg, Lena von Bahr, Gabriel Afram, Carina Lindström, Per Ljungman, Nina Heldring, Peter Petzelbauer, Karin Garming Legert, Nadir Kadri and Katarina Le Blanc. Treatment of Chronic GvHD with Mesenchymal Stromal Cells Induces Durable Responses; a Phase II Study. Stem Cells Transl Med. 2020 Oct;9(10):1190-1202. doi: 10.1002/sctm.20-0099. Epub 2020 Jun 23. PMID: 32573983
  5. Tove Kamsvåg, Anncarin SvanbergKarin Garming LegertJohan ArvidsonLouise von EssenKarin MellgrenJacek ToporskiJacek Winiarski & Gustaf Ljungman. Prevention of oral mucositis with cryotherapy in children undergoing hematopoietic stem cell transplantations—a feasibility study and randomized controlled trial. Support Care Cancer. 2020 Oct;28(10):4869-4879. doi: 10.1007/s00520-019-05258-2. Epub 2020 Jan 28. PMID: 31993753 
  6. Berglund S, Watz E, Remberger M, Garming Legert K, Axdorph-Nygell U, Sundin M, Uhlin M, Mattsson J. Granulocyte transfusions could benefit patients with severe oral mucositis after allogeneic hematopoietic stem cell transplantation. Vox Sang. 2019 Oct;114(7):769-777. doi: 10.1111/vox.12835. Epub 2019 Aug 11.PMID: 31402469
  7. Tollemar V, Tudzarovski N, Boberg E, Törnqvist Andrén A, Al-Adili A, Le Blanc K, Garming Legert K, Bottai M, Warfvinge G, Sugars R. Quantitative Chromogenic Immunohistochemical Image Analysis in CellProfiler Software. Cytometry A. 2018 Oct;93(10):1051-1059. doi: 10.1002/cyto.a.23575
  8. Brennan M, Hasséus B, Hovan A, Raber-Durlacher JE, Blijlevens N, Huysmans MC, Legert KG, Johansson JE, Moore CG, von Bültzingslöwen I. Research Protocol: Multicenter Study to Establish the Impact of Oral Side Effects from Conditioning Therapy Before Hematopoietic Stem Cell Transplantation “Ora-Stem Study”. JMIR Research Protocols 2018;7(4): e103 doi:10.2196/resprot.8982
  9. Toxicological effects of fludarabine and treosulfan conditioning before allogeneic stem-cell transplantation. Remberger M, Törlen J, Serafi IE, Garming-Legert K, Björklund A, Ljungman P, Sundin M, Hassan M, Mattsson J.  Int J Hematol. 2017 Oct;106(4):471-475
  10. A prospective randomized trial comparing cyclosporine/methotrexate and tacrolimus/sirolimus as graft-versus-host disease prophylaxis after allogeneic hematopoietic stem cell transplantation. Törlén J, Ringdén O, Garming-Legert K, Ljungman P, Winiarski J,  Remes K,  Itälä-Remes M, Remberger M, Mattsson J. Haematologica 2016; 101(11):1417-1425
  11. The relationship between oral mucositis and levels of pro-inflammatory cytokines in serum and in gingival crevicular fluid in allogeneic stem cell recipients. Garming Legert Karin, Tsilingaridis G, Remberger Mats, Ringdèn Olle, Heimdahl Anders Yucel-Lindberg, Tülay, Dahllöf Göran. JSSC 2015 23:6 1749-57. Doi:1007/s00520-014-2538-z
  12. Activated innate lymphoid cells are associated with a reduced susceptibility to graft versus host disease. Marius J. Munneke, Andreas T. Bjorklund, Jenny M. Mjosberg, Karin Garming-Legert, Jochem H. Bernink, Bianca Blom, Cynthia Huisman, Marinus H.J. van Oers, Hergen Spits, Karl-Johan Malmberg, and Mette D. Hazenberg. Blood 2014; 5: 812-821
  13. Reduced intensity conditioning and oral care measures prevent oral mucositis and reduces days of hospitalization in allogeneic stem cell transplantation recipients. Karin Garming Legert, Mats Remberger, Olle Ringdén, Anders Heimdahl, Göran Dahllöf. JSCC 2014; 22: 2133–2140
  14. A prospective randomized toxicity-study comparing reduced-intensity conditioning and myeloablative conditioning in patients with myeloid leukemia undergoing allogeneic hematopoietic stem cell transplantation. Olle Ringdén, Tom Erkers, Johan Aschan, Karin Garming-Legert, Katarina Le Blanc, Hans Hägglund, Brigitta Omazic, Petter Svenberg, Göran Dahllöf, Jonas Mattsson, Per Ljungman and Mats Remberger. J Intern Med. 2013; 274: 153-162
  15. Sirolimus and tacrolimus as immune prophylaxis compared to cyclosporine with or without methotrexate in patients undergoing allogeneic haematopoietic stem cell transplantation for non-malignant disorders. Ringdén O, Remberger M, Dahllöf G, Garming-Legert K, Karlsson H, Svenberg P et al European Journal of Haematology 2011; 87: 503–509
  16. Improved survival after allogeneic hematopoietic stem cell transplantation in recent years. A single-center study. Remberger M, Ackefors M, Berglund S, Blennow O, Dahllöf G, Dlugosz A, Garming-Legert K, et al Biol Blood Marrow Transplant. 2011 Nov;17(11):1688-97
  17. Xerostomia in children and adolescents after stem cell transplantation conditioned with total body irradiation or busulfan. Dahllöf G, Wondimu B, Barr-Agholme M, Garming-Legert K, Remberger M, Ringdén O. Oral Oncol. 2011 Sep;47(9):915-9
  18. Long-term salivary function after conditioning with busulfan, fractionated or single dose TBI. Garming Legert K, Ringdén O, Remberger M, Heimdahl A, Dahllöf G. Oral Dis. 2011 Oct;17(7):670-6
  19. Salivary secretion after fractionated or single dose total body irradiation. Garming Legert K, Remberger M, Ringdèn O, Heimdahl A, Dahllöf G.Bone Marrow Transplant. 2012 Mar;47(3):404-10
  20. Development and characterisation of an animal model of dental sinusitis. Garming Legert K, Melén I, Heimdahl A, Stierna P. Acta Otolaryngol. 2005; 125(11):1195-1202

 

Review articles

  1. Basic oral care for haematology–oncology patients and haematopoietic stem cell transplantation recipients: a position paper from the joint task force of the Multinational Association of Supportiv e Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Group for Blood and Marrow Transplantation (EBMT). Elad S, Raber-Durlacher J, Brennan M, Saunders D, Mank A, Zadik Y, Quinn B, Epstein J, Blijlevens N, Waltimo T, Passweg J, Correra E, Dahllöf G, Garming Legert K et al. JSCC 2015 Jan;23(1):223-36. doi: 10.1007/s00520-014-2378-x. Epub 2014 Sep 5.
  2. Sinusitis of periodontal or periapical origin - Pathophysiological implications for early treatment. Garming Legert K, Zimmerman M, Stierna P. Acta Otolaryngol 2004; 124: 655-663

 

Letters to the editor

  1. Stromal Progenitor Cell Modulation by Thalidomide in the Treatment of Oral Chronic Graft versus Host Disease. Davies L, Emma Board-Davies, Shamlou B, Boberg E, Garming Legert K, Le Blanc K.  Cytotherapy, 2018; 20: 755-758
  2. Enhanced oral healing following local mesenchymal stromal cell therapy. Karin Garming-Legert, Gregory Tour, Rachael Sugars, Lena von Bahr, Lindsay C. Davies, Katarina Le Blanc. Oral Onkology 2015; 51(12): E97-E98

Pedagogiska meriter

Pedagogical profile

Orofacial medicine with focus on oral mucosal lesions and conditions, as well as acute and chronic oral complications after high-dose chemotherapy and/or stem cell transplantation.

 

Pedagogical expertise

  • Subject Lead in Orofacial Medicine, dept of Dental Medicine
  • Program Director Dental Education
  • Program Director Complementary Education for Dentists from Outside EU/EES and Switzerland
  • Chair of the Working Group for the development of the new Dental Education Study Plan - implemented August 2019
  • Chair of the Program Committee for the Dental eEducation
  • Chair of the Examination Board for the Dental Education
  • Member of the Working Group for the development of the Study Plan for the  Dental Specialist Training Program in Orofacial Medicine - implemented January 2020

 

Current teaching activities

Dental Undergrade Education

  • Course Leader for Healthy and Diseased Mouth (2TL058 – 3 hp)
  • Course Leader for Orofacial Medicine 1 (2TL063 – 3 hp)
  • Course Leader for Orofacial Medicine 3
  • Lecturer in Orofacial Medicine and Clinical Oral Pathology
  • Supervision of exam degree projects

Dental Hygienist Education

  • Module Responsible and Lecturer in Orofacial Medicine (1TY014 – 1,5 hp)

Postgraduate education

  • Lecturer in Orofacial medicine
  • Clinical supervisor in Orofacial Medicine
  • Supervisor in Master and Doctoral education.

Utbildning

Specialist in Orofacial Medicine, 2019

PhD in Medical Science, 2011

Study program in Dentistry, 1993

Study program in Nursing, 1987

 

Akademiska priser och utmärkelser

Member of Pedagogiska Akademin, Karolinska Institutet

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