Dental treatment of patients with leukemia should be planned on the basis of antineoplastic therapy which can be chemotherapy with or without radiotherapy and bone marrow transplantation. Many are the oral manifestations presented by these patients, arising from leukemia and/or treatment. In addition, performing dental procedures at different stages of treatment (before, during, or after) must follow certain protocols in relation to the haematological indices of patients, aimed at maintaining health and contributing to the effectiveness of the results of antineoplastic therapy. Through a literature review, the purpose of this study was to report the hematological abnormalities present in patients with leukemia, trying to correlate them with the feasibility of dental treatment at different stages of the disease. It is concluded in this paper that dental treatment in relation to haematological indices presented by patients with leukemia must follow certain protocols, mainly related to neutrophil and platelet counts, and the presence of the dentist in a multidisciplinary team is required for the health care of this patient.
Background
Studies suggest that the ingestion of fish oil (FO), a source of the omega‐3 polyunsaturated fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), can reduce the deleterious side‐effects of chemotherapy. The aim of this randomised clinical trial was to evaluate the effect of supplementation with oral FO for 9 weeks on nutritional parameters and inflammatory nutritional risk in patients with haematological malignancies during the beginning of chemotherapy.
Methods
Twenty‐two patients with leukaemia or lymphoma were randomised to the unsupplemented group (UG) (n = 13) or supplemented group (SG) (n = 9). SG received 2 g/day of fish oil for 9 weeks. Nutritional status, serum acute‐phase proteins and plasma fatty acids were evaluated before (T0) and after (T1) the intervention period. Data were analysed using two models; model 1, comprising data from all patients included in the study, and model 2, comprising data from UG patients with no increase in the proportions of EPA and DHA in plasma and data from SG patients showing an at least 100% increase in plasma EPA and DHA.
Results
SG showed an increased plasma proportion of EPA and DHA in both models. In model 2, C‐reactive protein (CRP) and CRP/albumin ratio showed larger reductions in the SG. Overall long‐term survival in both models (465 days after the start of the chemotherapy) was higher in the group ingesting fish oil (P < 0.05).
Conclusions
These findings indicate an improved nutritional‐inflammatory risk and potential effects on long‐term survival in patients with haematological malignancies supplemented with FO during the beginning of chemotherapy.
This study aimed to understand how patients perceive their oral health and the resulting oral manifestations of antineoplastic chemotherapy, as well as to analyze the impact of these alterations on oral health-related quality of life. A total of 80 patients undergoing treatment participated in this study. A questionnaire was applied using the Oral Health Impact Profile (OHIP-14) index and open interviews. Items with the highest impact prevalence included "worsened taste of food sensation" (35.00%), "discomfort in eating food" (20.00%), and "feeling stressed" (17.50%). The outpatients showed the highest prevalence scores, whereas the inpatients presented higher quality of life impact severity. The ways in which the patients perceived how their oral alteration affected their quality of life were distinct and subjective. It is important that dentists act together with a multiprofessional team developing strategies to alleviate the impact of the disease and chemotherapy on oral cavity and patients' quality of life.
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