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Periodontal Infection in Patients With Acute Nonlymphocytic Leukemia: Prevalence of Acute Exacerbations

Periodontal Infection in Patients With Acute Nonlymphocytic Leukemia: Prevalence of Acute... 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 (< 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. (Arch Intern Med 1982;142:551-554) References 1. Schimpff SC, Young VM, Greene WH, et al: Origin of infection in acute nonlymphocytic leukemia: Significance of hospital acquisition of potential pathogens. Ann Intern Med 1972;77:707-714.Crossref 2. Levine AS, Schimpff SC, Graw RG, et al: Hematologic malignancies and other marrow failure states: Progress in the management of complicating infections. Semin Hematol 1974;11:141-202. 3. Schimpff SC, Aisner J, Wiernik PH: Infection in acute nonlymphocytic leukemia: The alimentary canal as a major source of pathogens , in van der Waaij D, Verhoef J (eds): New Criteria for Antimicrobial Therapy: Maintenance of Digestive Tract Colonization Resistance . Amsterdam, Excerpta Medica, 1979, pp 12-29. 4. Henefer EP, Nelson JF, Beaupre EM: Palatal enlargement in chronic lymphocytic leukemia: Report of a case. J Oral Surg 1970;28:371-375. 5. Carl W, Schaf NG: Dental care for the cancer patient. J Surg Oncol 1974;6:293-310.Crossref 6. Goepp RA: Mandibular lesion in a patient with acute lymphocytic leukemia. J Oral Pathol 1976;5:60-64.Crossref 7. Bottomley WK, Perlin E, Ross GR: Antineoplastic agents and their oral manifestations. Oral Surg 1977;44:527-534.Crossref 8. Segelman AE, Doku HC: Treatment of the oral complications of leukemia. J Oral Surg 1977;35:469-477. 9. Sela MN, Pisanti S: Early diagnosis and treatment of patients with leukemia: A dental problem. J Oral Med 1977;32:46-50. 10. Lindquist SF, Hickey AJ, Drane JB: Effect of oral hygiene on stomatitis in patients receiving cancer chemotherapy. J Prosthet Dent 1978;40:312-314.Crossref 11. Dreizen S, McCredie KB, Dicke KA, et al: Oral complications of bone marrow transplantation in adults with acute leukemia. Postgrad Med 1979;66:187-194. 12. Lockhart PB, Sonis ST: Relationship of oral complications to peripheral blood leukocyte and platelet counts in patients receiving cancer chemotherapy. Oral Surg 1979;48:21-28.Crossref 13. Greene JC, Vermillion JR: The simplified oral hygiene index. J Am Dent Assoc 1964;68:7-13. 14. Goldman HM, Cohen DW: Periodontal Therapy . St Louis, CV Mosby Co, 1968, p 64. 15. Bodey GP, Buckley M, Sathe YS, et al: Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med 1966;64:328-340.Crossref 16. Sickles EA, Greene WH, Wiernik PH: Clinical presentation of infection in granulocytopenic patients. Arch Intern Med 1975;135:715-719.Crossref 17. Peterson DE, Overholser CD: Dental management of leukemic patients. Oral Surg 1979;47:40-42.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Periodontal Infection in Patients With Acute Nonlymphocytic Leukemia: Prevalence of Acute Exacerbations

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340160131025
Publisher site
See Article on Publisher Site

Abstract

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 (< 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. (Arch Intern Med 1982;142:551-554) References 1. Schimpff SC, Young VM, Greene WH, et al: Origin of infection in acute nonlymphocytic leukemia: Significance of hospital acquisition of potential pathogens. Ann Intern Med 1972;77:707-714.Crossref 2. Levine AS, Schimpff SC, Graw RG, et al: Hematologic malignancies and other marrow failure states: Progress in the management of complicating infections. Semin Hematol 1974;11:141-202. 3. Schimpff SC, Aisner J, Wiernik PH: Infection in acute nonlymphocytic leukemia: The alimentary canal as a major source of pathogens , in van der Waaij D, Verhoef J (eds): New Criteria for Antimicrobial Therapy: Maintenance of Digestive Tract Colonization Resistance . Amsterdam, Excerpta Medica, 1979, pp 12-29. 4. Henefer EP, Nelson JF, Beaupre EM: Palatal enlargement in chronic lymphocytic leukemia: Report of a case. J Oral Surg 1970;28:371-375. 5. Carl W, Schaf NG: Dental care for the cancer patient. J Surg Oncol 1974;6:293-310.Crossref 6. Goepp RA: Mandibular lesion in a patient with acute lymphocytic leukemia. J Oral Pathol 1976;5:60-64.Crossref 7. Bottomley WK, Perlin E, Ross GR: Antineoplastic agents and their oral manifestations. Oral Surg 1977;44:527-534.Crossref 8. Segelman AE, Doku HC: Treatment of the oral complications of leukemia. J Oral Surg 1977;35:469-477. 9. Sela MN, Pisanti S: Early diagnosis and treatment of patients with leukemia: A dental problem. J Oral Med 1977;32:46-50. 10. Lindquist SF, Hickey AJ, Drane JB: Effect of oral hygiene on stomatitis in patients receiving cancer chemotherapy. J Prosthet Dent 1978;40:312-314.Crossref 11. Dreizen S, McCredie KB, Dicke KA, et al: Oral complications of bone marrow transplantation in adults with acute leukemia. Postgrad Med 1979;66:187-194. 12. Lockhart PB, Sonis ST: Relationship of oral complications to peripheral blood leukocyte and platelet counts in patients receiving cancer chemotherapy. Oral Surg 1979;48:21-28.Crossref 13. Greene JC, Vermillion JR: The simplified oral hygiene index. J Am Dent Assoc 1964;68:7-13. 14. Goldman HM, Cohen DW: Periodontal Therapy . St Louis, CV Mosby Co, 1968, p 64. 15. Bodey GP, Buckley M, Sathe YS, et al: Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med 1966;64:328-340.Crossref 16. Sickles EA, Greene WH, Wiernik PH: Clinical presentation of infection in granulocytopenic patients. Arch Intern Med 1975;135:715-719.Crossref 17. Peterson DE, Overholser CD: Dental management of leukemic patients. Oral Surg 1979;47:40-42.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1982

References