Browse > Article
http://dx.doi.org/10.7314/APJCP.2016.17.3.911

Leukemic Oral Manifestations and their Management  

Francisconi, Carolina Favaro (Bauru School of Dentistry, University of Sao Paulo, Department of Biological Sciences)
Caldas, Rogerio Jardim (Bauru School of Dentistry, University of Sao Paulo, Department of Stomatology)
Martins, Lazara Joyce Oliveira (Bauru School of Dentistry, University of Sao Paulo, Department of Stomatology)
Rubira, Cassia Maria Fischer (Bauru School of Dentistry, University of Sao Paulo, Department of Stomatology)
da Silva Santos, Paulo Sergio (Bauru School of Dentistry, University of Sao Paulo, Department of Stomatology)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.17, no.3, 2016 , pp. 911-915 More about this Journal
Abstract
Leukemia is the most common neoplastic disease of the white blood cells which is important as a pediatric malignancy. Oral manifestations occur frequently in leukemic patients and may present as initial evidence of the disease or its relapse. The symptoms include gingival enlargement and bleeding, oral ulceration, petechia, mucosal pallor, noma, trismus and oral infections. Oral lesions arise in both acute and chronic forms of all types of leukemia. These oral manifestations either may be the result of direct infiltration of leukemic cells (primary) or secondary to underlying thrombocytopenia, neutropenia, or impaired granulocyte function. Despite the fact that leukemia has long been known to be associated with oral lesions, the available literature on this topic consists mostly of case reports, without data summarizing the main oral changes for each type of leukemia. Therefore, the present review aimed at describing oral manifestations of all leukemia types and their dental management. This might be useful in early diagnosis, improving patient outcomes.
Keywords
Leukemia; early diagnosis; oral manifestations; dental care;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Anirudhan D, Bakhshi S, Xess I, et al (2008). Etiology and outcome of oral mucosal lesions in children on chemotherapy for acute lymphoblastic leukemia. Indian Pediatr, 45, 47-51.
2 Aronovich S, Connolly TW (2008). Pericoronitis as an initial manifestation of acute lymphoblastic leukemia: a case report. J Oral and Maxillofacial Surgery, 66, 804-8.   DOI
3 Arvanitidou I-E, Nikitakis NG, Sklavounou A (2011). Oral manifestations of T-cell large granular lymphocytic leukemia: a case report. Journal of oral & maxillofacial Res, 2.
4 Auluck A, Zhang L, Desai R, et al (2008). Primary malignant melanoma of maxillary gingiva--a case report and review of the literature. J Can Dent Assoc, 74, 367-71.
5 Benson RE, Rodd HD, North S, et al (2007). Leukaemic infiltration of the mandible in a young girl. Int J Paediatr Dent, 17, 145-50.   DOI
6 Brady-West DC, Richards L, Thame J, et al (1998). Cancrum oris (noma) in a patient with acute lymphoblastic leukaemia. A complication of chemotherapy induced neutropenia. West Indian Med J, 47, 33-4.
7 Campo E, Swerdlow SH, Harris NL, et al (2011). The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood, 117, 5019-32.   DOI
8 Castella A, Davey FR, Elbadawi A, et al (1984). Granulocytic sarcoma of the hard palate: report of the first case. Hum Pathol, 15, 1190-2.   DOI
9 Cattaneo E (1966). [Inflammatory cellular reactions in the oral cavity of patients with chronic myeloid leukemia]. Arch Stomatol, 7, 281-6.
10 Cooper CL, Loewen R, Shore T (2000). Gingival hyperplasia complicating acute myelomonocytic leukemia. J Canadian Dental Associat, 66, 78-9.
11 Copete MA, Sheridan DP (2000). Large granular lymphocyte leukemia and its association with oral neutropenic ulcerations: A case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 90, 474-7.   DOI
12 Cotran RS, Kumar V, Collins T, et al (1999). White cells and lymph nodes. In 'Robbins pathologic basis of disease', Eds 657-8
13 da Silva-Santos PS, Silva BS, Coracin FL, et al (2010). Granulocytic sarcoma of the oral cavity in a chronic myeloid leukemia patient: an unusual presentation. Med Oral Patol Oral Cir Bucal, 15, 350-2.
14 da Silva Santos PS, Fontes A, de Andrade F, et al (2010). Gingival leukemic infiltration as the first manifestation of acute myeloid leukemia. Otolaryngol Head Neck Surgery, 143, 465-6.   DOI
15 Eichhorst B, Robak T, Montserrat E, et al (2015). Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 26, 78-84.
16 Dean A, Ferguson J, Marvanr E (2003). Acute leukaemia presenting as oral ulceration to a dental emergency service. Australian Dental J, 48, 195-7.   DOI
17 Declerck D, Vinckier F (1988). Oral complications of leukemia. Quintessence Int, 19, 575-83.
18 Deschler B, Lubbert M (2006). Acute myeloid leukemia: epidemiology and etiology. Cancer, 107, 2099-107.   DOI
19 Epstein JB, Epsteinb JD, Le ND, et al (2001). Characteristics of oral and paraoral malignant lymphoma: a population-based review of 361 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 92, 519-25.   DOI
20 Greenberg MS, Glick M (2003). Benign tumors of the oral cavity. In 'Burket's oral medicine: Diagnosis & Treatment', Eds PMPH-USA, 137-94
21 Greenberg MS, Glick M (2008). Doencas Hematologicas In 'Medicina Oral de Burket', Eds 429-53
22 Guan G, Firth N (2015). Oral manifestations as an early clinical sign of acute myeloid leukaemia: a case report. Australian Dental J, 60, 123-7.   DOI
23 Hasan S, Khan NI, Reddy LB (2015). Leukemic gingival enlargement: Report of a rare case with review of literature. Int J Appl Basic Med Res, 5, 65-7.   DOI
24 Henefer E, Nelson J, Beaupre E (1970). Palatal enlargement in chronic lymphocytic leukemia: report of case. J Oral Surgery, 28, 371.
25 Hou GL, Huang JS, Tsai CC (1997). Analysis of oral manifestations of leukemia: a retrospective study. Oral Dis, 3, 31-8.   DOI
26 Katz J, Peretz B (2002). Trismus in a 6 year old child: a manifestation of leukemia? Journal of Clinical Pediatric Dentistry, 26, 337-9.   DOI
27 Howard MR, Hamilton PJ (2008). Leukaemia. In 'Haematology', Eds Philadelphia, 33-66
28 Jabbour EJ, Faderl S, Kantarjian HM (2005). Adult acute lymphoblastic leukemia. Mayo Clin Proc, 80, 1517-27.   DOI
29 Jemal A, Thomas A, Murray T, et al (2002). Cancer statistics, 2002. CA Cancer J Clin, 52, 23-47.   DOI
30 Kemp S, Gallagher G, Kabani S, et al (2008). Oral non-Hodgkin's lymphoma: review of the literature and World Health Organization classification with reference to 40 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 105, 194-201.   DOI
31 Long RG, Hlousek L, Doyle JL (1998). Oral manifestations of systemic diseases. Mt Sinai J Med, 65, 309-15.
32 Lopes AC (2009). Myelodysplastic syndromes In 'Tratado de clinica medica', Eds Roca, 2039-50
33 Martini V, Schiavone P, Bonacina R, et al (2013). NK leukemia: a rare case of oral manifestations representing the initial sign. Ann Stomatol (Roma), 4, 28.
34 Osterne RL, Matos-Brito RG, Alves AP, et al (2009). Oral granulocytic sarcoma: a case report. Med Oral Patol Oral Cir Bucal, 14, 232-5.
35 Pai A, Prasad S, Dyasanoor S (2012). Acute leukemias: a dentist’s perspective. Minerva Stomatol, 61, 233-8.
36 Papamanthos MK, Kolokotronis AE, Skulakis HE, et al (2010). Acute myeloid leukaemia diagnosed by intra-oral myeloid sarcoma. A case report. Head Neck Pathol, 4, 132-5.   DOI
37 Richards A, Costelloe M, Eveson J, et al (2000). Oral mucosal non-Hodgkin's lymphoma-a dangerous mimic. Oral Oncol, 36, 556-8.   DOI
38 Presant CA, Safdar SH, Cherrick H (1973). Gingival leukemic infiltration in chronic lymphocytic leukemia. Oral Surgery, Oral Med, Oral Pathol, 36, 672-4.   DOI
39 Puumala SE, Ross JA, Aplenc R, et al (2013). Epidemiology of childhood acute myeloid leukemia. Pediatr Blood Cancer, 60, 728-33.   DOI
40 Reenesh M, Munishwar S, Rath SK (2012). Generalised leukaemic gingival enlargement: a case report. J Oral Maxillofac Res, 3, 5.
41 Rubnitz JE, Gibson B, Smith FO (2010). Acute myeloid leukemia. Hematol Oncol Clin North Am, 24, 35-63.   DOI
42 Santos PSS, Neri D, Bigelli N, et al (2011). Noma-like lesion in a patient with acute promyelocytic leukemia. Rev Bras Hematol Hemoter, 33, 321-2.   DOI
43 Semenzato G, Zambello R, Starkebaum G, et al (1997). The lymphoproliferative disease of granular lymphocytes: updated criteria for diagnosis. Blood, 89, 256-60.
44 Sepulveda E, Brethauer U, Fernandez E, et al (2012). Oral manifestations as first clinical sign of acute myeloid leukemia: report of a case. Pediatric Dentistry, 34, 418-21.
45 Silva BA, Siqueira CR, Castro PH, et al (2012). Oral manifestations leading to the diagnosis of acute lymphoblastic leukemia in a young girl. J Indian Soc Pedod Prev Dent, 30, 166-8.   DOI
46 Sklavounou-Andricopoulou A, Piperi E, Paikos S (2002). Oral and maxillofacial manifestations of malignant haemopoietic and lymphoreticular disorders: Part IIA. Haema, 5, 305-19.
47 Sonis ST, Fazio RC 1995. Principles and Practice of Oral Medicine, WB Saunders.
48 Valera MC, Noirrit-Esclassan E, Pasquet M, et al (2015). Oral complications and dental care in children with acute lymphoblastic leukaemia. J Oral Pathol Med, 44, 483-9.   DOI
49 Stafford R, Sonis S, Lockhart P, et al (1980). Oral pathoses as diagnostic indicators in leukemia. Oral Surgery, Oral Med, Oral Pathol, 50, 134-9.   DOI
50 Urquhart A, Berg R (2001). Hodgkin’s and non-Hodgkin’s lymphoma of the head and neck. Laryngoscope, 111, 1565-9.   DOI
51 Williams WJ, Beutler E, Erslev AJ, et al (1990). Hematology. In Eds McGraw Hill, New York, 243-4
52 Xie Z, Zhang F, Song E, et al (2007). Intraoral granulocytic sarcoma presenting as multiple maxillary and mandibular masses: a case report and literature review. Oral Surgery, Oral Med, Oral Pathol, Oral Radiol, Endodontol, 103, 44-8.   DOI
53 Yeoh AE, Tan D, Li CK, et al (2013). Management of adult and paediatric acute lymphoblastic leukaemia in Asia: resource-stratified guidelines from the Asian Oncology Summit 2013. Lancet Oncol, 14, 508-23.   DOI
54 Zimmermann C, Meurer MI, Grando LJ, et al (2015). Dental treatment in patients with leukemia. J Oncol, 2015, 571739.