Oral mucosal lesions in patients with acute leukemia and related disorders during cytotoxic therapy.

This study reports the presence of oral mucosal lesions in 26 patients with acute leukemia during the initial weeks of treatment (induction period). For comparison, three groups of patients without malignant disorders (acute disorders, long-term hospitalization, antibiotic treatment) were included. All patients were treated at the University Hospital of Umeå, Sweden. During the period of hospitalization hemorrhages were seen in 14 of the 26 patients with leukemia. No specific location was found. A correlation between presence of hemorrhages and low platelet counts was noted. Eighteen of the patients revealed ulcerations during the period. Ulcerations were predominantly found on the buccal mucosa, the lips, and the tongue. A tendency to an increase in the number and severity of ulcers was noted during the period of induction therapy. A correlation between presence of ulcers and low granulocyte counts was found. Candidiasis-like changes were seen in eight of the patients with leukemia. Compared with the patients with leukemia the patients in the reference groups showed a low prevalence of oral mucosal lesions.