Tooth Abnormalities and Their Age-Dependent Occurrence in Leukemia Survivors

SIMPLE SUMMARY: Despite the multidrug nature of anticancer treatment, attempts are still being made to determine the relationship between the duration of chemotherapy, the dose of individual drugs, and the occurrence of dental developmental abnormalities. There are relatively few papers devoted to this issue, and all of them are based on the study groups composed of individuals receiving various treatment regimens. The current study includes a group of acute lymphoblastic leukemia survivors who underwent chemotherapy according to the ALL IC-BFM 2002 protocol. Contrary to the observations of some authors, the results of the current research suggest that the age at the start of chemotherapy is likely to be the strongest risk factor for toxic injury during tooth development. A small study cohort is a major limitation, but an evaluation of similar relationships at larger research centers would be helpful in better understanding the problem. ABSTRACT: The multidrug nature of anticancer treatment and different treatment protocols used in the studies are likely to be a major limitation in establishing real risk factors determining the occurrence of dental abnormalities. The authors aimed to establish a relationship between the duration and the dose of chemotherapy and the number of tooth adverse effects in the group receiving the same treatment. Of the 40 anticancer therapy recipients who attended the outpatient dental clinic, 7 leukemia survivors receiving the treatment according to the ALL IC-BFM 2002 protocol were selected. The study group consisted of four females and three males aged 92 to 207 months at the time of dental examination and 29 to 91 months at leukemia diagnosis. As a result of the clinical and radiological examination, dental abnormalities such as agenesis, tooth size reduction, root abnormalities, and taurodontia were identified, and the medical records of all survivors were reviewed in terms of drugs administered, their doses, and treatment schedules. No correlation was observed between the treatment duration of an intensive therapy, the entire therapy, and the number of tooth abnormalities. No relationship was also found between the number of dental abnormalities and the cumulative dose of vincristine, L-asparaginase, methotrexate, cyclophosphamide, cytarabine, and 6-mercaptopurine. The age at the onset of antineoplastic therapy is likely to be the strongest risk factor for toxic injury during tooth development.