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급성 골수성 백혈병의 구강 내 발현 및 치료: 증례 보고
ORAL MANIFESTATION AND TREATMENT OF ACUTE MYELOID LEUKEMIA: A CASE REPORT

김지연    (서울대학교 치의학대학원 구강악안면외과학교실   ); 민승기    (서울대학교 치의학대학원 구강악안면외과학교실   ); 임호경    (서울대학교 치의학대학원 구강악안면외과학교실   ); 서진원    (서울대학교 치의학대학원 구강악안면외과학교실   ); 황순정    (서울대학교 치의학대학원 구강악안면외과학교실  );
  • 초록

    Proliferation of abnormal hematopoietic cells with impaired differentiation, regulation and programmed cell death leads to leukemia. AML(acute myeloid leukemia) is a malignancy with malfunction of myeloid hematopoietic cells with acute behavior. The oral manifestations of the disease are posterior palate hemorrhage, gingival bleeding and gingival ulceration as a result of infection by normal oral flora and gingival infiltration by leukemic cells. A 49-year-old male patient was referred from local dental clinic. The patient was diagnosed with AML FAB M1 (acute myeloid leukemia French-American-British classification M1 myeloblastic leukemia without maturation). The oral infection focus was removed by a conservative treatment. 2 days after the dental treatment, the patient underwent chemotherapy. At 8-month follow-up, the overall outcome was excellent. Oral manifestations of AML are often the first indications of the malignancy. Therefore it is essential for dentists, especially oral and maxillofacial surgeons, to be aware of the diagnostic signs and complications associated with leukemia for better diagnosis and subsequent treatment and management.


  • 주제어

    Acute myeloid leukemia .   Oral manifestation .   Dental treatment prior to chemotherapy.  

  • 참고문헌 (15)

    1. Seoul National University College of Medicine : Hematology, Seoul, Seoul National University Press, 1999, p.155 
    2. Stafford R, Sonis S, Lockhart P et al : Oral pathoses as diagnostic indicators in leukemia. Oral Surg Oral Med Oral Pathol 50 : 134, 1980 
    3. An updated legal perspective on antibiotic prophylaxis : American Dental Association Division of Legal Affairs. J Am Dent Assoc 139 Suppl : 10S, 2008 
    4. Bodey GP : Oral complications of the myeloproliferative diseases. Postgrad Med 49 : 115, 1971 
    5. Koulocheris P, Metzger MC, Kesting MR et al : Lifethreatening complications associated with acute monocytic leukaemia after dental treatment. Aust Dent J 54 : 45, 2009 
    6. Fauci AS, Braunwald E, Kasper DL et al : Harrison's Principles of Internal Medicine, 17th ed. the United States of America, the McGraw-Hill, 2008, p.677 
    7. Kim BG, Kim SG, Yeo HH et al : Osteomyelitis occurring leukemia patient: a case report. J Kor Oral Maxillofac Surg 26 : 310, 2000 
    8. Salisbury PL, 3rd, Caloss R, Jr., Cruz JM et al : Mucormycosis of the mandible after dental extractions in a patient with acute myelogenous leukemia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 83 : 340, 1997 
    9. Burke VP, Startzell JM : The leukemias. Oral Maxillofac Surg Clin North Am 20 : 597, 2008 
    10. Neville BW DD, Allen CM, Bouquot JE : Oral & Maxillofacial Pathology, 2nd ed. Philadelphia, WB Saunders, 2002, p.626 
    11. Demirer S, Ozdemir H, Sencan M et al : Gingival hyperplasia as an early diagnostic oral manifestation in acute monocytic leukemia: a case report. Eur J Dent 1 : 111, 2007 
    12. Wu J, Fantasia JE, Kaplan R : Oral manifestations of acute myelomonocytic leukemia: a case report and review of the classification of leukemias. J Periodontol 73 : 664, 2002 
    13. Chi JH, Yeo HH, Kim YK et al : Leukemia : a case report. J Kor Oral Maxillofac Surg 22 : 230, 1996 
    14. Cho SY, Cheng AC, Cheng MC : Oral care for children with leukaemia. Hong Kong Med J 6 : 203, 2000 
    15. Kennedy HF, Morrison D, Tomlinson D et al : Gingivitis and toothbrushes: potential roles in viridans streptococcal bacteraemia. J Infect 46 : 67, 2003 

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  • 임호경 (2)

  • 서진원 (3)

  • 황순정 (60)

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