Hematolojik ve Onkolojik Hastalıkların Oral Belirtileri
Özet
Oral bulgular hematolojik ve onkolojik hastalıkların ilk belirtileri olabileceği gibi, tedaviye bağlı olarak da görülebilmektedir. Hematolojik ve onkolojik hastalıklar oral mukozayı, periodontal dokuları, dişleri, gingivayı, tükrük bezlerini etkileyebilir ve klinik pratikte nadir değildir. Hematolojik hastalıkları benign ve malign hematolojik hastalıklar olarak ayıracak olursak malign hastalıklar içinde en sık lösemi, lenfomaya bağlı oral belirtiler görülür. Bu belirtiler malign hücreler tarafından oral yumuşak ve sert dokuların infiltrasyonuna, kemik iliği hücrelerinin infiltrasyonuna bağlı olarak görülebilir. Ayrıca bu hastalıkların tedavisine sekonder gelişen mukozit ek sık gözlenen bulgulardandır. Benign hastalıklar içinde de anemiler, trombositopeniler ve koagülasyon bozuklukları oral belirtiler ile prezente olur. Onkolojik hastalıklarda da benzer şekilde oral malign tümöral kitle ve tedavi ile ilişkili belirti ve bulgular görülebilir. Bu bölümde hematolojik ve onkolojik hastalıkların oral belirtileri ve tedavi toksisitelerine bağlı gelişen durumlardan bahsedilecektir.
Oral manifestations may be the first symptoms of hematological and oncological diseases, or they may be associated with treatment. Hematological and oncological diseases can affect the oral mucosa, periodontal tissues, teeth, gingiva, salivary glands and are not uncommon in clinical practice. If we divide hematological diseases into benign and malignant hematological diseases, in malignant diseases, oral symptoms are most commonly seen due to leukemia and lymphoma. These symptoms may occur due to infiltration of oral soft and hard tissues by malignant cells and infiltration of bone marrow cells. In addition, mucositis developing secondary to the treatment of these diseases is one of the more common presentations. In benign diseases, anemia, thrombocytopenia and coagulation disorders present with oral symptoms. Signs and symptoms related to oral malignant tumor mass and treatment may also be observed in oncological diseases. In this chapter, oral symptoms of hematological and oncological diseases and situations that develop due to treatment toxicities will be discussed.
Referanslar
Tebbi CK. Etiology of acute leukemia: A review. Cancers. 2021;13(9):2256.
Raina R, Gondhi NK, Chaahat, Singh D, Kaur M, Lee H-N. A systematic review on acute leukemia detection using deep learning techniques. Archives of Computational Methods in Engineering. 2023;30(1):251-70.
Demirer S, Özdemir H, Şencanc M, Marakoğlud I. Gingival hyperplasia as an early diagnostic oral manifestation in acute monocytic leukemia: a case report. European journal of dentistry. 2007;1(02):111-4.
Yacoub A, Mahalwar G. Dentist to Oncologist: Gingival Hyperplasia in AML Accompanied By Periodontal Infection-Case Report. Blood. 2016;128(22):5187.
Ficarra G, Silverman S, Jr., Quivey JM, Hansen LS, Giannotti K. Granulocytic sarcoma (chloroma) of the oral cavity: a case with aleukemic presentation. Oral Surg Oral Med Oral Pathol. 1987;63(6):709-14.
Warme B, Sullivan J, Tigrani DY, Fred DM. Chloroma of the forearm: a case report of leukemia recurrence presenting with compression neuropathy and tenosynovitis. Iowa Orthop J. 2009;29:114-6.
Silva TDB, Ferreira CBT, Leite GB, de Menezes Pontes JR, Antunes HS. Oral manifestations of lymphoma: a systematic review. Ecancermedicalscience. 2016;10.
Kemp S, Gallagher G, Kabani S, Noonan V, O'Hara C. Oral non-Hodgkin's lymphoma: review of the literature and World Health Organization classification with reference to 40 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(2):194-201.
Mozaffari E, Mupparapu M, Otis L. Undiagnosed multiple myeloma causing extensive dental bleeding: report of a case and review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(4):448-53.
Wu Y-C, Wang Y-P, Chang JY-F, Cheng S-J, Chen H-M, Sun A. Oral manifestations and blood profile in patients with iron deficiency anemia. Journal of the Formosan Medical Association. 2014;113(2):83-7.
Chiang C-P, Chang JY-F, Wang Y-P, Wu Y-H, Wu Y-C, Sun A. Atrophic glossitis: Etiology, serum autoantibodies, anemia, hematinic deficiencies, hyperhomocysteinemia, and management. Journal of the Formosan medical association. 2020;119(4):774-80.
Chiriac A, Chiriac AE, Pinteala T, Spinei A, Savin L, Zelenkova H, et al. Angular cheilitis—an oral disease with many facets. Wiener Medizinische Wochenschrift. 2024:1-8.
Chi AC, Neville BW, Krayer JW, Gonsalves WC. Oral manifestations of systemic disease. American family physician. 2010;82(11):1381-8.
Amagasa T, Yamashiro M, Uzawa N. Oral premalignant lesions: from a clinical perspective. International journal of clinical oncology. 2011;16:5-14.
Warnakulasuriya S, Johnson NW, Van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. Journal of oral pathology & medicine. 2007;36(10):575-80.
Mortazavi H, Baharvand M, Mehdipour M. Oral potentially malignant disorders: an overview of more than 20 entities. Journal of dental research, dental clinics, dental prospects. 2014;8(1):6.
Ernani V, Saba NF. Oral cavity cancer: risk factors, pathology, and management. Oncology. 2015;89(4):187-95.
Fatahzadeh M, Schwartz RA. Oral Kaposi's sarcoma: a review and update. International journal of dermatology. 2013;52(6):666-72.
Kusiak A, Jereczek-Fossa BA, Cichońska D, Alterio D. Oncological-Therapy Related Oral Mucositis as an Interdisciplinary Problem—Literature Review. International Journal of Environmental Research and Public Health. 2020;17(7):2464.
Villa A, Vollemans M, De Moraes A, Sonis S. Concordance of the WHO, RTOG, and CTCAE v4. 0 grading scales for the evaluation of oral mucositis associated with chemoradiation therapy for the treatment of oral and oropharyngeal cancers. Supportive Care in Cancer. 2021;29:6061-8.
Barasch A, Peterson DE. Risk factors for ulcerative oral mucositis in cancer patients: unanswered questions. Oral oncology. 2003;39(2):91-100.
Liu X, Lorusso P, Mita M, Piha-Paul S, Hong DS, Fu S, et al. Incidence of mucositis in patients treated with temsirolimus-based regimens and correlation to treatment response. Oncologist. 2014;19(4):426-8.
Bossi P, Lucchesi M, Antonuzzo A. Gastrointestinal toxicities from targeted therapies: measurement, duration and impact. Current Opinion in Supportive and Palliative Care. 2015;9(2):163-7.
Elting LS, Chang YC, Parelkar P, Boers-Doets CB, Michelet M, Hita G, et al. Risk of oral and gastrointestinal mucosal injury among patients receiving selected targeted agents: a meta-analysis. Support Care Cancer. 2013;21(11):3243-54.
Sonis S, Andreotta P, Lyng G. On the pathogenesis of mTOR inhibitor‐associated stomatitis (mIAS)—studies using an organotypic model of the oral mucosa. Oral diseases. 2017;23(3):347-52.
De Oliveira MA, e Martins FM, Wang Q, Sonis S, Demetri G, George S, et al. Clinical presentation and management of mTOR inhibitor-associated stomatitis. Oral oncology. 2011;47(10):998-1003.
Miroddi M, Sterrantino C, Simonelli I, Ciminata G, Phillips RS, Calapai G. Risk of grade 3-4 diarrhea and mucositis in colorectal cancer patients receiving anti-EGFR monoclonal antibodies regimens: A meta-analysis of 18 randomized controlled clinical trials. Critical Reviews in Oncology/Hematology. 2015;96(2):355-71.
Yuan A, Kurtz SL, Barysauskas CM, Pilotte AP, Wagner AJ, Treister NS. Oral adverse events in cancer patients treated with VEGFR-directed multitargeted tyrosine kinase inhibitors. Oral oncology. 2015;51(11):1026-33.
Hubiche T, Valenza B, Chevreau C, Fricain JC, Del Giudice P, Sibaud V. Geographic tongue induced by angiogenesis inhibitors. The oncologist. 2013;18(4):e16-e7.
Sundar S, Burge F. Geographical tongue induced by axitinib. Case Reports. 2015;2015:bcr2015211318.
Gavrilovic IT, Balagula Y, Rosen AC, Ramaswamy V, Dickler MN, Dunkel IJ, et al. Characteristics of oral mucosal events related to bevacizumab treatment. The Oncologist. 2012;17(2):274-8.
Ena P, Chiarolini F, Siddi G, Cossu A. Oral lichenoid eruption secondary to imatinib (Glivec®). Journal of dermatological treatment. 2004;15(4):253-5.
Klein BA, Alves FA, de Santana Rodrigues Velho J, Vacharotayangul P, Hanna GJ, LeBoeuf NR, et al. Oral manifestations of immune‐related adverse events in cancer patients treated with immune checkpoint inhibitors. Oral Diseases. 2022;28(1):9-22.
Soo-Young Y, Jae Joon H, Sun Kyung B, Hong Jun K, Chi Hoon M. Pembrolizumab-induced severe oral mucositis in a patient with squamous cell carcinoma of the lung: A case study. Lung Cancer. 2020;147:21-5.
Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, et al. Bisphosphonate‐associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. John Wiley and Sons and The American Society for Bone and Mineral Research …; 2007. p. 1479-91.
BISPHOSPHONATES AO. Systematic review: Bisphosphonates and osteonecrosis of the jaws. Ann Intern Med. 2006;144:753-61.
Gligorov J, Bastit L, Gervais H, Henni M, Kahila W, Lepille D, et al. Prevalence and treatment management of oropharyngeal candidiasis in cancer patients: results of the French CANDIDOSCOPE study. International Journal of Radiation Oncology* Biology* Physics. 2011;80(2):532-9.
Kragelund C, Reibel J, Pedersen AML. Oral candidiasis and the medically compromised patient. Oral infections and general health: From molecule to chairside. 2016:65-77.
Referanslar
Tebbi CK. Etiology of acute leukemia: A review. Cancers. 2021;13(9):2256.
Raina R, Gondhi NK, Chaahat, Singh D, Kaur M, Lee H-N. A systematic review on acute leukemia detection using deep learning techniques. Archives of Computational Methods in Engineering. 2023;30(1):251-70.
Demirer S, Özdemir H, Şencanc M, Marakoğlud I. Gingival hyperplasia as an early diagnostic oral manifestation in acute monocytic leukemia: a case report. European journal of dentistry. 2007;1(02):111-4.
Yacoub A, Mahalwar G. Dentist to Oncologist: Gingival Hyperplasia in AML Accompanied By Periodontal Infection-Case Report. Blood. 2016;128(22):5187.
Ficarra G, Silverman S, Jr., Quivey JM, Hansen LS, Giannotti K. Granulocytic sarcoma (chloroma) of the oral cavity: a case with aleukemic presentation. Oral Surg Oral Med Oral Pathol. 1987;63(6):709-14.
Warme B, Sullivan J, Tigrani DY, Fred DM. Chloroma of the forearm: a case report of leukemia recurrence presenting with compression neuropathy and tenosynovitis. Iowa Orthop J. 2009;29:114-6.
Silva TDB, Ferreira CBT, Leite GB, de Menezes Pontes JR, Antunes HS. Oral manifestations of lymphoma: a systematic review. Ecancermedicalscience. 2016;10.
Kemp S, Gallagher G, Kabani S, Noonan V, O'Hara C. Oral non-Hodgkin's lymphoma: review of the literature and World Health Organization classification with reference to 40 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(2):194-201.
Mozaffari E, Mupparapu M, Otis L. Undiagnosed multiple myeloma causing extensive dental bleeding: report of a case and review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(4):448-53.
Wu Y-C, Wang Y-P, Chang JY-F, Cheng S-J, Chen H-M, Sun A. Oral manifestations and blood profile in patients with iron deficiency anemia. Journal of the Formosan Medical Association. 2014;113(2):83-7.
Chiang C-P, Chang JY-F, Wang Y-P, Wu Y-H, Wu Y-C, Sun A. Atrophic glossitis: Etiology, serum autoantibodies, anemia, hematinic deficiencies, hyperhomocysteinemia, and management. Journal of the Formosan medical association. 2020;119(4):774-80.
Chiriac A, Chiriac AE, Pinteala T, Spinei A, Savin L, Zelenkova H, et al. Angular cheilitis—an oral disease with many facets. Wiener Medizinische Wochenschrift. 2024:1-8.
Chi AC, Neville BW, Krayer JW, Gonsalves WC. Oral manifestations of systemic disease. American family physician. 2010;82(11):1381-8.
Amagasa T, Yamashiro M, Uzawa N. Oral premalignant lesions: from a clinical perspective. International journal of clinical oncology. 2011;16:5-14.
Warnakulasuriya S, Johnson NW, Van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. Journal of oral pathology & medicine. 2007;36(10):575-80.
Mortazavi H, Baharvand M, Mehdipour M. Oral potentially malignant disorders: an overview of more than 20 entities. Journal of dental research, dental clinics, dental prospects. 2014;8(1):6.
Ernani V, Saba NF. Oral cavity cancer: risk factors, pathology, and management. Oncology. 2015;89(4):187-95.
Fatahzadeh M, Schwartz RA. Oral Kaposi's sarcoma: a review and update. International journal of dermatology. 2013;52(6):666-72.
Kusiak A, Jereczek-Fossa BA, Cichońska D, Alterio D. Oncological-Therapy Related Oral Mucositis as an Interdisciplinary Problem—Literature Review. International Journal of Environmental Research and Public Health. 2020;17(7):2464.
Villa A, Vollemans M, De Moraes A, Sonis S. Concordance of the WHO, RTOG, and CTCAE v4. 0 grading scales for the evaluation of oral mucositis associated with chemoradiation therapy for the treatment of oral and oropharyngeal cancers. Supportive Care in Cancer. 2021;29:6061-8.
Barasch A, Peterson DE. Risk factors for ulcerative oral mucositis in cancer patients: unanswered questions. Oral oncology. 2003;39(2):91-100.
Liu X, Lorusso P, Mita M, Piha-Paul S, Hong DS, Fu S, et al. Incidence of mucositis in patients treated with temsirolimus-based regimens and correlation to treatment response. Oncologist. 2014;19(4):426-8.
Bossi P, Lucchesi M, Antonuzzo A. Gastrointestinal toxicities from targeted therapies: measurement, duration and impact. Current Opinion in Supportive and Palliative Care. 2015;9(2):163-7.
Elting LS, Chang YC, Parelkar P, Boers-Doets CB, Michelet M, Hita G, et al. Risk of oral and gastrointestinal mucosal injury among patients receiving selected targeted agents: a meta-analysis. Support Care Cancer. 2013;21(11):3243-54.
Sonis S, Andreotta P, Lyng G. On the pathogenesis of mTOR inhibitor‐associated stomatitis (mIAS)—studies using an organotypic model of the oral mucosa. Oral diseases. 2017;23(3):347-52.
De Oliveira MA, e Martins FM, Wang Q, Sonis S, Demetri G, George S, et al. Clinical presentation and management of mTOR inhibitor-associated stomatitis. Oral oncology. 2011;47(10):998-1003.
Miroddi M, Sterrantino C, Simonelli I, Ciminata G, Phillips RS, Calapai G. Risk of grade 3-4 diarrhea and mucositis in colorectal cancer patients receiving anti-EGFR monoclonal antibodies regimens: A meta-analysis of 18 randomized controlled clinical trials. Critical Reviews in Oncology/Hematology. 2015;96(2):355-71.
Yuan A, Kurtz SL, Barysauskas CM, Pilotte AP, Wagner AJ, Treister NS. Oral adverse events in cancer patients treated with VEGFR-directed multitargeted tyrosine kinase inhibitors. Oral oncology. 2015;51(11):1026-33.
Hubiche T, Valenza B, Chevreau C, Fricain JC, Del Giudice P, Sibaud V. Geographic tongue induced by angiogenesis inhibitors. The oncologist. 2013;18(4):e16-e7.
Sundar S, Burge F. Geographical tongue induced by axitinib. Case Reports. 2015;2015:bcr2015211318.
Gavrilovic IT, Balagula Y, Rosen AC, Ramaswamy V, Dickler MN, Dunkel IJ, et al. Characteristics of oral mucosal events related to bevacizumab treatment. The Oncologist. 2012;17(2):274-8.
Ena P, Chiarolini F, Siddi G, Cossu A. Oral lichenoid eruption secondary to imatinib (Glivec®). Journal of dermatological treatment. 2004;15(4):253-5.
Klein BA, Alves FA, de Santana Rodrigues Velho J, Vacharotayangul P, Hanna GJ, LeBoeuf NR, et al. Oral manifestations of immune‐related adverse events in cancer patients treated with immune checkpoint inhibitors. Oral Diseases. 2022;28(1):9-22.
Soo-Young Y, Jae Joon H, Sun Kyung B, Hong Jun K, Chi Hoon M. Pembrolizumab-induced severe oral mucositis in a patient with squamous cell carcinoma of the lung: A case study. Lung Cancer. 2020;147:21-5.
Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, et al. Bisphosphonate‐associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. John Wiley and Sons and The American Society for Bone and Mineral Research …; 2007. p. 1479-91.
BISPHOSPHONATES AO. Systematic review: Bisphosphonates and osteonecrosis of the jaws. Ann Intern Med. 2006;144:753-61.
Gligorov J, Bastit L, Gervais H, Henni M, Kahila W, Lepille D, et al. Prevalence and treatment management of oropharyngeal candidiasis in cancer patients: results of the French CANDIDOSCOPE study. International Journal of Radiation Oncology* Biology* Physics. 2011;80(2):532-9.
Kragelund C, Reibel J, Pedersen AML. Oral candidiasis and the medically compromised patient. Oral infections and general health: From molecule to chairside. 2016:65-77.
