Periodontal infection in patients with acute nonlymphocyte leukemia. Prevalence of acute exacerbations

Abstract

From the initiation of chemotherapy until attainment of complete remission, 22 newly diagnosed, hospitalized patients with acute nonlymphocytic leukemia were studied for the prevalence of periodontal disease at admission and for acute exacerbations during myelosuppressive chemotherapy. Consistent with a normal population, all patients had asymptomatic periodontal disease at admission. In these 22 patients, 47 acute infections developed, including 13 of periodontal origin. All but three acute periodontal infections occurred during pronounced granulocytopenia (less than 100 granulocytes per microliter). Although signs and symptoms of inflammation were minimal, all 13 episodes were associated with pain and fever. Asymptomatic periodontal disease is readily overlooked but can be easily diagnosed by thorough clinical and roentgenographic examination. Its occurrence in patients with acute leukemia and its acute exacerbation during granulocytopenia indicate that this oral infection is associated with considerable morbidity during the treatment of acute nonlymphocytic leukemia.

Febrile neutropenia and periodontitis: lessons from a case periodontal treatment in the intervals between chemotherapy cycles for leukemia reduced febrile neutropenia

“…On the other hand, redness of the gingiva was not remarkable despite advanced periodontitis, probably because his neutrophil count was low. 7 This patient received HCT following a total of 3 cycles of chemotherapy. After recovery from neutropenia induced by initial chemotherapy, periodontal treatment was performed in each interval period of chemotherapy.…”

“…The incidence of so-called acute periodontal infections in previous studies showed significant disparity [10]. For example, 28% of all clinically defined infections in 22 leukemia patients that developed neutropenic fever during remission induction therapy were reported to be periodontitis [7]. However, in subsequent investigations, acute periodontal infections either did not develop at all [8,11] or only very infrequently [13].…”

“…Patients with periodontitis harbor periodontal pathogens, many of which are gram-negative facultatively anaerobic bacteria [10]. There is evidence that pre-existing periodontal infections may induce fever and that microorganisms may spread systemically [2,5,7,9].…”

Prise en charge des foyers infectieux bucco-dentaires

“…Néanmoins la décision de conservation d'une dent était adaptée en fonction de sa valeur stratégique. Les lésions endodontiques asymptomatiques s'aggravent rarement pendant la chimiothérapie [116], à l'inverse des lésions parodontales [117][118][119][120].…”

“…Enfin, plusieurs études s'accordent sur le fait que le traitement bucco-dentaire avant une chimiothérapie permettrait de réduire les épisodes fébriles et les infections pendant les cures [118,[122][123][124].…”