University of Damascus, Faculty of Dentistry, Department of Oral Medicine, Damascus, Syrian Arab Republic.
University of Damascus, Faculty of Medicine, Damascus, Syrian Arab Republic.
Medicine (Baltimore). 2024 Jan 12;103(2):e36780. doi: 10.1097/MD.0000000000036780.
Neutropenia can be caused by a variety of congenital and acquired factors, with Chemotherapy-induced myelosuppression being the most common cause. Neutropenia significantly affects oral health, leading to the manifestation of oral lesions such as ulcers, fungal and viral infections, and mucositis. This study aims to investigate oral lesions in patients with hematological malignancies who developed neutropenia after chemotherapy. This cross-sectional study included 50 patients with hematological malignancies. The participants were divided into 2 groups: the first group consisted of 25 patients with hematological malignancies who developed chemotherapy-induced neutropenia and the second group consisted of 25 patients with hematological malignancies who did not develop chemotherapy-induced neutropenia. Patients were assigned to one of the groups based on the absolute neutrophil count (ANC). Full oral clinical examination was performed to determine the presence of oral lesions. In the Chemotherapy-Induced Neutropenia group, the most common lesion was ulceration, observed in 12 patients (48%). Fungal infections were the second most common, present in 5 patients (20%), followed by viral infections in 4 patients (15%), and mucositis, which occurred in a single patient (4%). A statistically significant association was found between neutropenia and the presence of oral ulcers (P value = .015). In contrast, in the Chemotherapy group, oral changes were less frequent. Fungal infections were the most common, occurring in 4 patients (15%), followed by oral mucositis in 3 patients (12%). Ulceration and viral infections were the least common, each observed in 1 patient (4%). The frequency of various forms of oral ulcers increases with the severity of neutropenia. However, there was no significant increase in other oral lesions in patients with neutropenia.
中性粒细胞减少症可由多种先天和后天因素引起，其中化疗引起的骨髓抑制是最常见的原因。中性粒细胞减少症会显著影响口腔健康，导致口腔病变的出现，如溃疡、真菌和病毒感染以及黏膜炎。本研究旨在探讨化疗后发生中性粒细胞减少症的血液病患者的口腔病变。这是一项横断面研究，纳入了 50 例血液病患者。将参与者分为两组：第一组由 25 例发生化疗诱导性中性粒细胞减少症的血液病患者组成，第二组由 25 例未发生化疗诱导性中性粒细胞减少症的血液病患者组成。根据绝对中性粒细胞计数（ANC）将患者分配到其中一组。进行全面的口腔临床检查以确定口腔病变的存在。在化疗诱导性中性粒细胞减少症组中，最常见的病变是溃疡，有 12 例患者（48%）出现这种情况。真菌感染是第二常见的病变，有 5 例患者（20%）出现，其次是病毒感染，有 4 例患者（15%）出现，只有 1 例患者（4%）出现黏膜炎。中性粒细胞减少症与口腔溃疡的存在之间存在统计学显著关联（P 值=.015）。相比之下，在化疗组中，口腔变化较少见。真菌感染是最常见的病变，有 4 例患者（15%）出现，其次是口腔黏膜炎，有 3 例患者（12%）出现。溃疡和病毒感染较为少见，各有 1 例患者（4%）出现。各种形式的口腔溃疡的发生率随着中性粒细胞减少症的严重程度而增加。然而，中性粒细胞减少症患者的其他口腔病变并没有显著增加。
