Periodontal infection in patients with acute nonlymphocyte leukemia. Prevalence of acute exacerbations.

From the initiation of chemotherapy until attainment of complete remission, 22 newly diagnosed, hospitalized patients with acute nonlymphocytic leukemia were studied for the prevalence of periodontal disease at admission and for acute exacerbations during myelosuppressive chemotherapy. Consistent with a normal population, all patients had asymptomatic periodontal disease at admission. In these 22 patients, 47 acute infections developed, including 13 of periodontal origin. All but three acute periodontal infections occurred during pronounced granulocytopenia (less than 100 granulocytes per microliter). Although signs and symptoms of inflammation were minimal, all 13 episodes were associated with pain and fever. Asymptomatic periodontal disease is readily overlooked but can be easily diagnosed by thorough clinical and roentgenographic examination. Its occurrence in patients with acute leukemia and its acute exacerbation during granulocytopenia indicate that this oral infection is associated with considerable morbidity during the treatment of acute nonlymphocytic leukemia.