PDF: Acute myeloid leukemia: a case report with palatal and lingual gingival alterations

Leukemia results from the proliferation of a clone of abnormal hematopoietic (HP) cells with impaired differentiation, regulation, and programmed cell death (apoptosis).

Leukemic cell multiplication at the expense of normal HP cell lines causes marrow failure, depressed blood cell count (cytopenia), and death as a result of infection, bleeding, or both. 

Oral lesions may be the presenting feature of acute leukemias and are therefore important diagnostic indicators of the disease. Such lesions may occur due to direct leukemic infiltration of tissues, or be secondary to immunodeficiency, anemia and thrombocytopenia. 

Read also: Rheumatoid arthritis and dental care consideration

Typical oral manifestations of acute leukemias include gingival swelling, oral ulceration, spontaneous gingival bleeding, petechiae, mucosal pallor, herpetic infections and candidosis2. AML is a clonal proliferation of immature myeloid cells. It presents with marrow failure and cytopenia. Symptoms include fever, fatigue, pallor, mucosal bleeding, petechiae, and local infection.

The French-American-British (FAB) classification system divides AML into 8
subtypes, M0 through to M7, based on the cell type from which the leukemia
developed and its degree of maturity3. Gingival infiltration represents a 5% frequency as the initial presenting complication of AML.