Late adverse effects of childhood acute lymphoblastic leukemia treatment on developing dentition

Egle Immonen, Atte Nikkilä, Timo Peltomäki, Liisa Aine, Olli Lohi

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background: Childhood cancer survivors show a variety of late adverse effects on dental health. The purpose of this study was to examine the prevalence and severity of dental abnormalities in permanent dentition in childhood leukemia survivors. Materials and methods: Retrospective analysis of panoramic radiographs was performed for 178 childhood leukemia survivors aged below 17 years at the time of diagnosis. Sex, age at diagnosis, interval between ALL diagnosis and the follow-up radiograph, treatment protocol, and risk grouping were recorded. Abnormalities of tooth development and defect index were used to assess the frequency and severity of dental abnormalities. Results: One hundred eight (61%) patients had no dental abnormalities at follow-up examination at a median of 6.1 years after diagnosis. Microdontia was more frequent in children under 6 years of age at the time of diagnosis (5.7% vs. 0.6%, p <.001). Significant differences were noted between distinct ALL treatment protocols with more common microdontia in patients treated according to the NOPHO ALL2008 protocol. Tooth agenesis was more frequent in patients that underwent therapy according to high-risk arms compared to intermediate- or standard-risk arms (3.8% vs. 1.4%, p =.01). Patients under 6 years of age at diagnosis had a significantly higher average defect index score than older patients (7.0 vs. 2.8, p =.01). Conclusions: Children and adolescents who received ALL treatment were at risk for dental damage. Young age and high-intensity therapy were associated with the severity of dental abnormalities.

Original languageEnglish
Article numbere29200
JournalPediatric Blood and Cancer
Volume68
Issue number9
DOIs
Publication statusPublished - Sep 2021
Publication typeA1 Journal article-refereed

Keywords

  • defect
  • dentition
  • development
  • leukemia
  • survivor

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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