Download PDF
Open Access
CC BY-NC-ND 4.0 · South Asian J Cancer 2025; 14(03): 615-621
DOI: 10.1055/s-0044-1790285
Original Article
Hematology Section

Intensive Oral Hygiene Interventions during Therapy of Acute Leukemia May Result in Detrimental Outcomes: A Randomized Clinical Trial

Authors

  • Biswajit Dubashi 

    1   Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India

  • Nirmal Pratap Mote

    2   Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India

  • B. Krishnan

    2   Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India

  • Smita Kayal

    1   Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India

  • K.T. Harichandra Kumar

    3   Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India

  • M. Abirami

    1   Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India

  • Nirmala Devi

    1   Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India

  • Prasanth Ganesan 

    1   Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India

  • Yadav Nisha

    1   Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India
Further Information
Also available at
  Permissions and Reprints

Abstract

Objectives

There are no standard guidelines on oro-dental care during induction therapy of acute leukemia (AL). This study aimed to assess the effect of intensive oral hygiene practice on oral mucositis, infection, and disease outcomes compared to standard clinical practice.

Materials and Methods

Newly diagnosed patients with AL were randomized to receive either standard oral hygiene protocol (group A, n = 92) or comprehensive oral hygiene protocol (group B, n = 91). In group A, the oral hygiene indexes were measured by the dentist at baseline and at the end of treatment. In group B, weekly monitoring of oral hygiene indexes by the dentist and interventions in the form of oral cavity inspection, probing for gum health, and use of a soft toothbrush and education on oral hygiene practices were carried out.

Results

The frequency of mucositis was higher in group B (60%) than in group A (40%; p = 0.09). There was no difference in the median Simplified Oral Hygiene Index (OHI-S; 0.5 vs. 0.6) and Silness and Loe plaque index (0.4 vs. 0.25) between the groups. The local (11 vs. 1%; p = 0.005) and systemic infection rate (82.2 vs. 65.2%; p = 0.009) were higher in group B than in group A.

Conclusion

This study failed to show the superiority of a comprehensive oral hygiene protocol compared to standard protocol in reducing oral mucositis in patients receiving induction therapy for AL. We hypothesize that frequent intervention in the oral cavity may lead to the dissemination of infection.

Keywords

oral hygiene - intervention - acute leukemia - intensive oral hygiene - Infection

Authors' Contribution

B.D. made substantial contributions to the conception and design of the work, acquisition and interpretation of data for the work, drafting the work, and revising it critically for important intellectual content, and gave final approval of the version to be published. N.P.M. contributed to data acquisition and gave final approval of the version to be published. K.B. made substantial contributions to the conception and design of the work, acquisition of data, and revising the manuscript critically for important intellectual content, and gave final approval of the version to be published. S.K. made substantial contributions to the conception and design of the work, acquisition of data, and revising the manuscript critically for important intellectual content, and gave final approval of the version to be published. K.T.H.K. contributed to the analysis and interpretation of data for the work and gave final approval of the version to be published. M.A. contributed to data acquisition and gave final approval of the version to be published. N.D. contributed to data acquisition and gave final approval of the version to be published. P.G. contributed to revising the manuscript critically for important intellectual content and gave final approval of the version to be published. Y.N. contributed to the analysis and interpretation of data for the work, revising the manuscript critically, and drafting the work, and gave final approval of the version to be published.


All the authors agreed to be accountable for all aspects of the work and to ensure that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.


Data and Code Availability

The datasets analyzed in this study are available with the corresponding author, which can be obtained on reasonable request. The datasets generated or analyzed during the current study are available from the corresponding author on reasonable request.


Ethical Approval and Consent to Participate

This study was approved by the JIPMER Institute ethics committee (JIP/IEC/2016/28/931). All data used in this study were anonymized and coded before use. Written informed consent was obtained from each participant after explaining the purpose and procedure and their contribution in the study in their vernacular language.


Supplementary Material



Publication History

Received: 02 February 2024

Accepted: 09 August 2024

Article published online:
18 September 2024

© 2024. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India