Oral manifestation of leukemic children under chemotherapy


Background: The term leukemia refers to cancers of the white blood cells (also called leukocytes or WBCs). When a child has leukemia, large numbers of abnormal white blood cells are produced in the bone marrow. These abnormal white cells crowd the bone marrow and flood the bloodstream, but they cannot perform their proper role of protecting the body against disease because they are defective. Most of the children with cancer will be at risk for significant pain at some time during the course of illness. Objective: To assess the oral manifestation in children with leukemia under chemotherapy treatment and its relation to the duration of patient's hospitalization.Patients and methods: One hundred twenty seven patients diagnosed Acute Lymphocytic Leukemia (ALL),collected from Children Welfare Teaching Hospital /Medical City, Central Child Teaching Hospital/Baghdad (hematology & oncology unit) from 25th January 2009 to 25th January 2010, the questionnaire including demographic & clinical information, main oral manifestations. Results: Patients samples ranged in age from (5 – 16) years, only 55 patients (43%) were aged from (8-10) years; 75patients (58.5%) were males;40 patients (31%) were living in south of Iraq. Swollen&palpable lymph node were the main chief complaints in 40 patients (31%); duration of disease is Less than 6 months, in 65 patients (51%); patients who stay in hospital more than 15 days were 90(70.8%); patients who their diagnosis were based on core biopsy & bone marrow biopsy were the most diagnostic methods in 40 (31%); in about half of the patients hematological tests showed that Thrombocytopenia &leucocytosis, elevated in erythrocytes sedimentation rate and anemia. Main oral manifestations presented were: ulceration gentle pressure, spontaneous bleeding, dry mouth, ulcerated/with or without bleeding of lips, laryngeal pain, unable to swallow and difficult/painful speech and mucositis.Conclusions: In this study we can conclude that the main oral manifestations in patient with leukemia were ulceration after gentle pressure; spontaneous bleeding; dry mouth; ulcerated/with or without bleeding of lips, laryngeal pain; unable to swallow and difficult/painful speech, and the duration of hospitalizations were related to the manifestations of patients and their chief complaints; diagnostic procedure and their therapy.Recommendation: the oral manifestations of patient with leukemia are focusing on them through a palliative measures such as the treatment of pain, and nutritional support and maintenance of good oral hygiene.