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Kanserli Çocuklarda Nötropeni ve Oral Enfeksiyonlar

Year 2021, Volume: 21 Issue: 2, 203 - 206, 20.09.2021

Abstract

Son yıllarda sağ kalım oranlarındaki artışa rağmen, çocukluk çağı kanserleri ölüm nedenleri arasında ilk sıralarda yer almaktadır. Oral ve sistemik enfeksiyonlar, yoğun tedavi protokolleri ile tedavi edilen kanserli hastaların yönetiminde önemli sorunlardan biridir. Kanserli hastalarda sepsisin en önemli ve en sık görülen kaynak yeri ağızdır. Mikroorganizmalar, normal mukoza bariyerinin bozulduğu mukozit gibi durumlarda dolaşıma katılarak sistemik enfeksiyonların gelişmesine neden olabilir. Tedavi sırasında oral enfeksiyonlar, hastaların %40-90’ında görülebilir. Enfeksiyonla ilişkili risk faktörleri; nötropeni/nötrofil fonksiyonlarında bozukluk, lenfopeni/lenfosit fonksiyonlarında bozukluk, mukozit, ağız kuruluğu, yetersiz beslenme, kötü oral hijyen, kanserin tipi, evresi ve tedavi protokolü, önceki oral/oral dışı enfeksiyonların öyküsü, geçirilmiş pulpal, periodontal hastalık, perikoronit ve endodontik tedavi öyküsü olarak sayılabilir. Kanser tanısı konulan hastalar, tedavi öncesi diş hekimi tarafından görülmeli, tedavi öncesi yeterli zamanı varsa, diş dolgusu, çekimi, periodontal bakım ve tedavisi planlanmalıdır. Ancak çocuklarda büyüme hızı yüksek tümörler görüldüğünden tanı ve tedavide daha hızlı yaklaşım gereklidir ve çoğu kez yeterli zaman yoktur. Sonuç olarak kanserli çocuklarda oral enfeksiyonlar, önemli bir morbidite ve mortalite nedenidir. Ağız ve diş muayenesi, kanser tanısı alan çocuklar- da tedavi öncesi değerlendirilmeli, tedavi sırasında da rutin muayenenin bir parçası olmalıdır. Hasta ve ailelerine bu konuda düzenli eğitim verilmelidir. Şüpheli lezyonlardan kültür ve/veya biyopsileri yapılmalı ve uygun tedavi gecikmeden başlanmalıdır.

References

  • 1. Elad S. Raber-Durlacher JE, Brennan MT, Saunders DP, Mank AP, Zadik Y. Basic Oral Care for Hematology-Oncology Patients and Hematopoietic Stem Cell Transplantation Recipients: A Position Paper From the Joint Task Force of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Society for Blood and Marrow Transplantation (EBMT). Support Care Cancer 2015:23:223-36. google scholar
  • 2. Wilberg P, Hjermstad MJ, Ottesen S, Herlofson BB. Oral Health Is an Important Issue in End-Of-Life Cancer Care. Support Care Cancer 2012;20:3115-22. google scholar
  • 3. Allen G, Logan R, Gue S. Oral Manifestations of Cancer Treatment in Children: A Review of the Literature. Clin J Oncol Nurs 2010;14:481-90. google scholar
  • 4. Otmani N, Alami R, Hessissen L, Mokhtari A, Soulaymani A, Khattab M. Determinants of Severe Oral Mucositis in Paediatric Cancer Patients: A Prospective Study. Int J Pediatr Dent 2011;21.211-6. google scholar
  • 5. Lalla RV, Latortue M, Hong C, Ariyawardana A, Palumbo S, Fischer D. A Systematic Review of Oral Fungal Infections in Patients Receiving Cancer Therapy. Support Care Cancer 2010;18:985-92. google scholar
  • 6. Brennan MT, Elting LS, Spijkervet FK. Systematic reviews of oral complications from cancer therapies, Oral Care Study Group, MASCC/ISOO: methodology and quality of the literature. Support Care Cancer 2010;18(8):979-84. google scholar
  • 7. Lerman M, Laudenbach J, Marty F, Baden L, Treister N. Management of Oral Infections in Cancer Patients. Dent Clin N Am 2008:52:129-53. google scholar

Neutropenia and Oral Infections in Children with Cancer

Year 2021, Volume: 21 Issue: 2, 203 - 206, 20.09.2021

Abstract

Despite the increase in survival rates, childhood cancers are among the leading causes of death. Oral and systemic infections are one of the most important problems in the management of cancer patients treated with intensive treatment protocols. The most important and common source of sepsis in patients with cancer is the mouth. Microorganisms can contribute to the development of systemic infections. The absence of a normal barrier facilitates sepsis in cases such as mucositis. Oral infections during treatment can be seen in 40-90% of patients. Risk factors associated with infection are neutropenia/ neutrophil dysfunction, impairment in lymphopenia/lymphocyte functions, mucositis, dry mouth, malnutrition, poor oral hygiene, type of cancer, stage, and treatment protocol, history of previous oral/non-oral infections, history of previous pulpal and periodontal disease, pericoronitis, and endodontic treatment. Patients diagnosed with cancer should be seen by the dentist before treatment, and if there is enough time before treatment, dental filling, extraction, and periodontal care and treatment should be planned. However, because tumors with a high growth rate are observed in children, a faster approach is required in diagnosis and treatment. Often, there is not enough time. As a result, oral infections are an important cause of morbidity and mortality in children with cancer. Oral and dental examination should be evaluated before treatment in children diagnosed with cancer. During treatment, they should also be part of the routine examination. Patients and their families should be given regular training in this regard. Culture and/or biopsies should be performed from suspicious lesions and appropriate treatment should be initiated without delay.

References

  • 1. Elad S. Raber-Durlacher JE, Brennan MT, Saunders DP, Mank AP, Zadik Y. Basic Oral Care for Hematology-Oncology Patients and Hematopoietic Stem Cell Transplantation Recipients: A Position Paper From the Joint Task Force of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Society for Blood and Marrow Transplantation (EBMT). Support Care Cancer 2015:23:223-36. google scholar
  • 2. Wilberg P, Hjermstad MJ, Ottesen S, Herlofson BB. Oral Health Is an Important Issue in End-Of-Life Cancer Care. Support Care Cancer 2012;20:3115-22. google scholar
  • 3. Allen G, Logan R, Gue S. Oral Manifestations of Cancer Treatment in Children: A Review of the Literature. Clin J Oncol Nurs 2010;14:481-90. google scholar
  • 4. Otmani N, Alami R, Hessissen L, Mokhtari A, Soulaymani A, Khattab M. Determinants of Severe Oral Mucositis in Paediatric Cancer Patients: A Prospective Study. Int J Pediatr Dent 2011;21.211-6. google scholar
  • 5. Lalla RV, Latortue M, Hong C, Ariyawardana A, Palumbo S, Fischer D. A Systematic Review of Oral Fungal Infections in Patients Receiving Cancer Therapy. Support Care Cancer 2010;18:985-92. google scholar
  • 6. Brennan MT, Elting LS, Spijkervet FK. Systematic reviews of oral complications from cancer therapies, Oral Care Study Group, MASCC/ISOO: methodology and quality of the literature. Support Care Cancer 2010;18(8):979-84. google scholar
  • 7. Lerman M, Laudenbach J, Marty F, Baden L, Treister N. Management of Oral Infections in Cancer Patients. Dent Clin N Am 2008:52:129-53. google scholar
There are 7 citations in total.

Details

Primary Language Turkish
Subjects Paediatrics
Journal Section Review
Authors

Şifa Şahin 0000-0001-7402-8944

Serap Karaman This is me 0000-0002-7428-3897

Publication Date September 20, 2021
Published in Issue Year 2021 Volume: 21 Issue: 2

Cite

APA Şahin, Ş., & Karaman, S. (2021). Kanserli Çocuklarda Nötropeni ve Oral Enfeksiyonlar. Journal of Child, 21(2), 203-206.
AMA Şahin Ş, Karaman S. Kanserli Çocuklarda Nötropeni ve Oral Enfeksiyonlar. Journal of Child. September 2021;21(2):203-206.
Chicago Şahin, Şifa, and Serap Karaman. “Kanserli Çocuklarda Nötropeni Ve Oral Enfeksiyonlar”. Journal of Child 21, no. 2 (September 2021): 203-6.
EndNote Şahin Ş, Karaman S (September 1, 2021) Kanserli Çocuklarda Nötropeni ve Oral Enfeksiyonlar. Journal of Child 21 2 203–206.
IEEE Ş. Şahin and S. Karaman, “Kanserli Çocuklarda Nötropeni ve Oral Enfeksiyonlar”, Journal of Child, vol. 21, no. 2, pp. 203–206, 2021.
ISNAD Şahin, Şifa - Karaman, Serap. “Kanserli Çocuklarda Nötropeni Ve Oral Enfeksiyonlar”. Journal of Child 21/2 (September 2021), 203-206.
JAMA Şahin Ş, Karaman S. Kanserli Çocuklarda Nötropeni ve Oral Enfeksiyonlar. Journal of Child. 2021;21:203–206.
MLA Şahin, Şifa and Serap Karaman. “Kanserli Çocuklarda Nötropeni Ve Oral Enfeksiyonlar”. Journal of Child, vol. 21, no. 2, 2021, pp. 203-6.
Vancouver Şahin Ş, Karaman S. Kanserli Çocuklarda Nötropeni ve Oral Enfeksiyonlar. Journal of Child. 2021;21(2):203-6.