Diagnosis, prophylaxis and treatment of oral complications in children with acute lymphoblastic leukemia. A narrative review

Q4 Medicine Revista Romana de Pediatrie Pub Date : 2022-12-31 DOI:10.37897/rjp.2022.4.5
L. Lazăr, C. Bică, Timea Dakó, M. Suciu, A. Lazar
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Abstract

Acute lymphoblastic leukemia (ALL) is a malignant condition defined by the proliferation of immature hematopoietic bone marrow cells, which replace the normal bone marrow elements. Furthermore, immature cells will accumulate in various areas of the body. Chemotherapeutic drugs are cytotoxic and have unwanted effects on normal cells. This toxicity is acute, or it may be chronic. Approximately 60% of survivors of ALL will suffer from one or more health problems or adverse side effects of this treatment. Oral complications are a frequent consequence of oncology therapy in pediatric patients. Xerostomia, carious lesions, gingivitis, tumors of the oral cavity, bone deformities of the jaw, temporomandibular joint disorders, trismus, and infections due to abundant microbial flora are common in these children. The risk of dental anomalies (dental or root agenesis, root malformations, enamel defects, dental hypoplasia) is higher in those who started treatment before permanent teeth erupt. All children are at risk of developing oral lesions due to poor hygiene, but children who have survived cancer are at even higher risk. The survival rate of children diagnosed with ALL has significantly increased thanks to remarkable advances in chemotherapy. Therefore, it is important that these patients are constantly monitored by the dentist to treat complications arising from the treatments in a timely manner. In children diagnosed with ALL, oral health is of great importance as the oral environment changes as a side effect of hematological disorders and their treatments. Treatment of carious lesions, periodontal problems and lesions of the oral mucosa must be done before starting chemotherapy by cleaning the oral cavity to eliminate any possible risk of infection. The participation of the dentist is important in improving the preventive protocols and oral examination of the pathological processes that occur in children with ALL. Interdisciplinary collaboration between physicians is essential during the treatment of pediatric cancer patients.
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儿童急性淋巴细胞白血病口腔并发症的诊断、预防和治疗。叙述性评论
急性淋巴细胞白血病(Acute lymphoblastic leukemia, ALL)是一种恶性疾病,其特征是未成熟的造血骨髓细胞增生,取代了正常的骨髓元素。此外,未成熟的细胞会积聚在身体的各个部位。化疗药物具有细胞毒性,对正常细胞有不良影响。这种毒性是急性的,也可能是慢性的。大约60%的ALL幸存者将遭受一种或多种健康问题或这种治疗的不良副作用。口腔并发症是儿科患者肿瘤治疗的常见后果。口腔干燥、龋齿、牙龈炎、口腔肿瘤、颚骨畸形、颞下颌关节紊乱、牙关紧闭以及由大量微生物菌群引起的感染在这些儿童中很常见。在恒牙长出之前就开始治疗的患者患牙畸形(牙或牙根发育不全、牙根畸形、牙釉质缺损、牙发育不全)的风险较高。由于卫生条件差,所有儿童都有患口腔病变的风险,但癌症幸存者的风险更高。由于化疗的显著进步,被诊断患有ALL的儿童的存活率显著提高。因此,这些病人必须由牙医持续监测,以及时处理治疗过程中出现的并发症。在被诊断为ALL的儿童中,口腔健康是非常重要的,因为口腔环境的改变是血液系统疾病及其治疗的副作用。治疗龋齿、牙周问题和口腔黏膜损伤必须在化疗开始前进行,清洁口腔以消除任何可能的感染风险。牙医的参与是重要的,以改善预防方案和口腔检查的病理过程,发生在儿童ALL。在儿科癌症患者的治疗过程中,医生之间的跨学科合作是必不可少的。
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CiteScore
0.10
自引率
0.00%
发文量
15
审稿时长
4 weeks
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