[Associated risk factors in developing oral manifestations in patients with blood dyscrasia]

The oral and dental complications arising in cancer patients can be attributable to the malignant disease itself and to the various modalities of cancer therapy. Up to 37.2% of all patients receiving cancer chemotherapy develop acute oral complications and up to 31.1% of all patients receiving cancer radiotherapy develop acute oral manifestations. Oral complications may result in significant morbidity, impaired nutrition, treatment delays, and dose reductions which are affecting the prognosis of the primary disease.

We investigated 312 cases of blood dyscrasia which 296 cases had oral manifestations (86.2%). They had a mean age of 40,6 years (range from 7 to 86 years). The male to female ratio was 1.0:0.75 (178/134). Data were statistically analyzed by t test, chi-square, Wilcoxon, Kruskal-Wallis and two-tailed exact Fischer, using the SPSS program, at a significance level of 5%.

Oral complications are frequently encountered in patients receiving anticancer therapy and these complications may result in significant morbidity, treatment delays, dose reductions, and nutritional deficiencies. The acute effects of anticancer chemotherapy upon the oral cavity include mucositis, infection, hemorrhage, xerostomia and nutritional deficiencies. Patients which undergo radiotherapy, specific in head and neck carcinomas, display a 30-60% incidence of the oral manifestations. The antineoplastic therapy will interfere with the turnover of the epithelial cells, followed by mucosal injury, later by infections, due to indirect invasion of Gram-negative bacteria and fungal species, as most of the anti-cancer drugs cause immunological changes.

The mucosal surface that is the oral cavity may provide insight into the immune function of the patient. Differential diagnosis is important as many disorders may manifest themselves similarly in the buccal area.