title: Prospective study of dental intervention for hematopoietic malignancy.
abstract: Various chemotherapeutic agents used in patients with hematopoietic malignancy cause serious side effects, including myelosuppression and immunosuppression. Immunosuppression makes patients more susceptible to infection, resulting in an increased risk of infectious complications, including the development of severe septicemia that may be life-threatening. It is necessary for dental staff to be familiar with an appropriate protocol in such cases and to share information about the chemotherapy with a hematologist. To verify the effectiveness of our dental intervention protocol, we conducted a prospective study on the incidence of complications for each myelosuppressive grade of chemotherapy in patients with hematopoietic malignancy. We compared the incidence of complications between treatment P (patients who finished all the dental treatments according to the protocol) and treatment Q (patients who did not) per grade (A, B, C, D) and incidence of systemic or oral findings. We also compared the incidence of oral complication related to the residual teeth between first chemo (patients who were undergoing chemotherapy for the first time) and prior chemo (not the first time). There were significant differences in inflammatory complications between treatment P and treatment Q. We found that both systemic and oral inflammatory complications increased with higher-grade myelosuppressive chemotherapy. Additionally, there was a significant difference between the incidence of oral complications related to the residual teeth between first chemo and prior chemo. Complete implementation of the dental intervention protocol was associated with fewer oral and systemic infectious and inflammatory complications in patients with hematopoietic malignancies undergoing chemotherapy. The incidence of oral and systemic complications also increased with grade of chemotherapy. These results support the validity of our dental intervention protocol. We should pay close attention to the oral state of de novo hematopoietic malignancy patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tsuji
authors.affiliation: Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya, Japan shibuya@med.nagoya-cu.ac.jp.
authors.forename: Y
authors.initials: Y
authors.lastname: Shibuya
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Akashi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Furudoi
authors.affiliation: Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yakushijin
authors.affiliation: Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kawamoto
authors.affiliation: Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Okamura
authors.affiliation: Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Matsuoka
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Komori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001853:Bone Marrow / Q000187:drug effects; D002985:Clinical Protocols; D017742:Dental Care for Chronically Ill; D003731:Dental Caries / Q000628:therapy; D017266:Dental Prosthesis; D005260:Female; D019337:Hematologic Neoplasms / Q000188:drug therapy*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000009:adverse effects; D009910:Oral Hygiene; D010510:Periodontal Diseases / Q000628:therapy; D011446:Prospective Studies; D014081:Tooth Extraction; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D019653:Myeloablative Agonists
keywords: chemotherapy; dental treatment protocol; inflammation; myelosuppressive grade; odontogenic infection; oral hygiene