Quispe Reyna Aguilar, Aguiar Elizabeth Marques, de Oliveira Claudia Teresa, Neves Ana Cristina Xavier, Santos Paulo Sérgio da Silva
Faculdade de Odontologia de Bauru da Universidade de São Paulo (FOB USP), Bauru, SP, Brazil.
Faculdade de Odontologia de Bauru da Universidade de São Paulo (FOB USP), Bauru, SP, Brazil.
Hematol Transfus Cell Ther. 2022 Jul-Sep;44(3):392-401. doi: 10.1016/j.htct.2021.08.006. Epub 2021 Nov 22.
The oral cavity can present the first clinical manifestations of leukemia, therefore; it is important to recognize their principal characteristics.
To identify oral manifestations as the first clinical signs of leukemia.
This is an integrative review, that gathered data from articles with oral manifestations of leukemia as part of its first clinical features. The were included case reports, case series, clinical research, or reviews with case reports. The variables that were considered relevant: age, sex, sites of the oral lesions, characteristics of the oral lesions, medical history and physical examination, time of evolution, radiographic examination, blood test results, initial diagnosis, differential diagnosis and final diagnosis.
A total of 31 studies were included, with a total of 33 individuals identified. There were 19 (57.57%) males and 14 (42.42%) females. The age range was from 1.6 to 74 years. Acute myeloid leukemia (72.72%) and acute lymphoid leukemia (18.18%) presented more oral manifestations as the first clinical signs of the disease. All individuals with leukemia presented lesions, such as ulcer, erosion, bleeding, ecchymosis, color change of the bluish or pale mucous membranes and areas of tissue necrosis. Hard tissue lesions were less frequent, being 6 (18.18%).
The first clinical manifestations of leukemia can be present in the oral cavity, mainly in acute myeloid leukemia. The principal oral tissues affected were gingival tissue, buccal mucosa and hard and/or soft palate. When hard tissues, such as the maxilla bone or mandible bone were affected, dental mobility was the principal clinical sign.
口腔可能呈现白血病的首发临床表现，因此，认识其主要特征很重要。
将口腔表现识别为白血病的首发临床体征。
这是一项整合性综述，收集了以白血病口腔表现作为其首发临床特征的文章数据。纳入的有病例报告、病例系列、临床研究或含病例报告的综述。考虑的相关变量包括：年龄、性别、口腔病变部位、口腔病变特征、病史和体格检查、病程、影像学检查、血液检查结果、初步诊断、鉴别诊断和最终诊断。
共纳入31项研究，共识别出33例个体。男性19例（57.57%），女性14例（42.42%）。年龄范围为1.6至74岁。急性髓系白血病（72.72%）和急性淋巴细胞白血病（18.18%）作为该病的首发临床体征出现更多口腔表现。所有白血病患者均有病变，如溃疡、糜烂、出血、瘀斑、 bluish或苍白黏膜的颜色改变以及组织坏死区域。硬组织病变较少见，为6例（18.18%）。
白血病的首发临床表现可出现在口腔，主要见于急性髓系白血病。主要受累的口腔组织为牙龈组织、颊黏膜以及硬腭和/或软腭。当上颌骨或下颌骨等硬组织受累时，牙齿松动是主要临床体征。
