1. ACUTE MYELOGENOUS LEUKEMIA
(AML)
Tesoro, Willianne C.
DMD-2D

2. ACUTE MYELOGENOUS LEUKEMIA
 (AML) is a clonal hematopoietic disorder
resulting from genetic alterations in normal
hematopoietic stem cells.
 These changes alter normal hematopoietic
growth and differentiation, resulting in an
accumulation of large numbers of
abnormal, immature myeloid cells in the bone
marrow and peripheral blood.
 These cells are capable of dividing and
proliferating, but cannot differentiate into
mature hematopoietic cells.
 AML is more common in men than women.
 AML is the most common acute leukemia
affecting adults, and its incidence increases
with age.

4. SIGNS AND SYMPTOMS
 Fever
 Fatigue
 Loss of appetite
 Weight loss
 Frequent infections
 Shortness of breath
 Weakness
 Swelling of lymph nodes
 Spleen/Liver enlargement
 Pallor
 Easy bleeding and bruising
 Petechiae (red spots) on the mucosa
 Gingival swelling
 Ulcers are often found on the mucosa or gingival
 Oral Candidiasis/Oral thrush

7. DENTAL CORRELATION OF THE DISEASE IN DENTAL
TREATMENT
 Hematological information is needed before any invasive procedures (such as
extractions )as leukemia patients have higher bleeding tendencies and they are
liable to infections.
 Preventive oral care is important in leukemia patients. Early intervention is
important to reduce the possible complications.
 Frequent topical fluoride applications
 Fissure sealants on the molars to reduce dental caries.
 Dietary advice to the patient
 Give proper tooth brushing instructions to both patient and parents.
 Antibiotic cover is needed before any surgery to prevent any postoperative
infection.
 Local anesthesia should be avoided to prevent any hemorrhagic tendency.
 Root canal treatment is preferred over extractions to reduce the risk for oral
and systemic complications
 Dental treatment should be performed as a traumatically as possible to
prevent any injuries to the soft tissues.
 Fixed and removable orthodontic appliances are not recommended for
patients with poor oral hygiene.
 Preshedding deciduous teeth should be left to exfoliate naturally and patient
should not play with it with his/her tongue to reduce bacteremia.
 Local measures such as placing sutures, gelatin sponge are required to
stop/arrest bleeding when a minor/major surgery is performed.

8.  Leukemia patients should maintain their oral
hygiene by:
 Brush twice daily using a soft toothbrush to reduce the risk
of significant bleeding and infection of the gingival.
 Attending the dental appointments regularly to monitor
their oral condition.
 Remove plaque effectively to prevent formation of
dental caries
 Rinse after meal to avoid accumulation of plaque/food
debris

9. CLASSIFICATION OF AML
 Multifactorial
-The barriers to curing AML are
multifactorial, including drug resistance, poor
tolerance of induction therapy, and very high rates
of relapse.
 Single Gene
- The affected people may have a single gene or
multiple genes in common. In some cases, families
tend to develop the same kinds of leukemia as
other members; in other families, affected people
may develop different forms of leukemia or related
blood cancers.
 Cytogenetics
- The translocation t(8;21)(q22;q22) is one of the
most common structural aberration in acute
myeloid leukemia and is found in 5-12% of AML