2. ACUTE MYELOGENOUS LEUKEMIA
(AML) is a clonal hematopoietic disorder
resulting from genetic alterations in normal
hematopoietic stem cells.
These changes alter normal hematopoietic
growth and differentiation, resulting in an
accumulation of large numbers of
abnormal, immature myeloid cells in the bone
marrow and peripheral blood.
These cells are capable of dividing and
proliferating, but cannot differentiate into
mature hematopoietic cells.
AML is more common in men than women.
AML is the most common acute leukemia
affecting adults, and its incidence increases
with age.
3.
4. SIGNS AND SYMPTOMS
Fever
Fatigue
Loss of appetite
Weight loss
Frequent infections
Shortness of breath
Weakness
Swelling of lymph nodes
Spleen/Liver enlargement
Pallor
Easy bleeding and bruising
Petechiae (red spots) on the mucosa
Gingival swelling
Ulcers are often found on the mucosa or gingival
Oral Candidiasis/Oral thrush
5.
6.
7. DENTAL CORRELATION OF THE DISEASE IN DENTAL
TREATMENT
Hematological information is needed before any invasive procedures (such as
extractions )as leukemia patients have higher bleeding tendencies and they are
liable to infections.
Preventive oral care is important in leukemia patients. Early intervention is
important to reduce the possible complications.
Frequent topical fluoride applications
Fissure sealants on the molars to reduce dental caries.
Dietary advice to the patient
Give proper tooth brushing instructions to both patient and parents.
Antibiotic cover is needed before any surgery to prevent any postoperative
infection.
Local anesthesia should be avoided to prevent any hemorrhagic tendency.
Root canal treatment is preferred over extractions to reduce the risk for oral
and systemic complications
Dental treatment should be performed as a traumatically as possible to
prevent any injuries to the soft tissues.
Fixed and removable orthodontic appliances are not recommended for
patients with poor oral hygiene.
Preshedding deciduous teeth should be left to exfoliate naturally and patient
should not play with it with his/her tongue to reduce bacteremia.
Local measures such as placing sutures, gelatin sponge are required to
stop/arrest bleeding when a minor/major surgery is performed.
8. Leukemia patients should maintain their oral
hygiene by:
Brush twice daily using a soft toothbrush to reduce the risk
of significant bleeding and infection of the gingival.
Attending the dental appointments regularly to monitor
their oral condition.
Remove plaque effectively to prevent formation of
dental caries
Rinse after meal to avoid accumulation of plaque/food
debris
9. CLASSIFICATION OF AML
Multifactorial
-The barriers to curing AML are
multifactorial, including drug resistance, poor
tolerance of induction therapy, and very high rates
of relapse.
Single Gene
- The affected people may have a single gene or
multiple genes in common. In some cases, families
tend to develop the same kinds of leukemia as
other members; in other families, affected people
may develop different forms of leukemia or related
blood cancers.
Cytogenetics
- The translocation t(8;21)(q22;q22) is one of the
most common structural aberration in acute
myeloid leukemia and is found in 5-12% of AML
