Dental Infection Screening Before Induction Chemotherapy for AML

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In a single-institution study reported in JCO Oncology Practice, Watson et al found that screening for and treating detected dental infections prior to initiation of induction chemotherapy for patients with newly diagnosed acute myeloid leukemia (AML) were associated with a significant reduction in infectious dental emergencies during treatment.

As stated by the investigators, “Patients with newly diagnosed AML are at risk of infection, including odontogenic infections, during induction chemotherapy. It is unknown whether clinical dental screening to diagnose and treat odontogenic disease in these patients can reduce the incidence of dental emergencies.”

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Study Details

The study included dental screening of 147 patients as part of a program before their admission for induction chemotherapy at Princess Margaret Cancer Centre between November 2014 and December 2016. A total of 190 patients who did not undergo screening constituted the unscreened control group; a total of 304 patients diagnosed with AML during the 26 months before initiation of the screening program constituted the prescreening group.

Key Findings

Among the 147 patients in the screened group, 6 had acute odontogenic disease treated prior to induction therapy. In total, one patient (0.68%) presented with an infectious odontogenic emergency during AML treatment.

In the unscreened group, eight patients (4.21%) developed an infectious odontogenic emergency during induction chemotherapy (P = .046 vs screened group).

In the prescreening group, 13 patients (4.28%) developed an infectious dental emergency during induction chemotherapy.

For the unscreened and prescreening groups combined, 21 (4.25%) of 494 patients developed an infectious dental emergency during induction treatment, representing a 6.25-fold increase over the 0.68% incidence in the screened group (P = .036).

The investigators concluded “Clinical dental screening before induction chemotherapy in patients with AML resulted in a 6-fold reduction in infectious dental emergencies during the induction period….clinical dental screenings intended to identify and treat acute odontogenic infections before induction chemotherapy require minimal resources to complete and are an effective means of preventing infectious odontogenic emergencies in patients with AML admitted for induction chemotherapy.”

Erin E. Watson, DMD, MHSc, of the Department of Dental Oncology and Maxillofacial Prosthetics, Princess Margaret Cancer Centre, Toronto, is the corresponding author for the JCO Oncology Practice article.

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