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Management of intraoral bleeding in patients with Waldenström macroglobulinemia: A protocol proposal
Author(s) -
Ueda Sei,
Ishii Kou,
Fujii Hitoshi,
Mizutani Konosuke,
Komaki Kanji,
Nagao Toru
Publication year - 2019
Publication title -
special care in dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.328
H-Index - 41
eISSN - 1754-4505
pISSN - 0275-1879
DOI - 10.1111/scd.12440
Subject(s) - medicine , macroglobulinemia , hyperviscosity syndrome , waldenstrom macroglobulinemia , hyperviscosity , oral hygiene , surgery , multiple myeloma , lymphoma , dentistry , blood viscosity
Aim Waldenström macroglobulinemia is a type of non‐Hodgkin lymphoma with poor prognosis observed in patients with hyperviscosity syndrome because of its tendency for fatal symptoms. This study investigated the risk of intraoral bleeding in patients with Waldenström macroglobulinemia based on hyperviscosity syndrome stage and oral health status, and described potential strategies for managing intraoral bleeding. Methods and results Between April 2012 and March 2017, seven patients with Waldenström macroglobulinemia underwent dental procedures or tooth extraction. Patient records were retrospectively reviewed to obtain data of symptoms, clinical and radiographic findings, treatment details, pretreatment hematological findings, hyperviscosity syndrome status, perioperative method for local haemostasis, postoperative bleeding, and prognosis. The mean patient age was 71.2 years, and the male‐to‐female ratio was 6:1. Treatment modalities for oral management comprised tooth extraction, scaling, and oral cavity cleaning. Three patients were admitted for hyperviscosity syndrome; one of the patients exhibited postoperative bleeding because of poor oral hygiene, whereas the two other patients with good oral hygiene did not experience intraoral bleeding regardless of the presence of hyperviscosity syndrome. Conclusion We recommended that the risk of oral bleeding in patients with Waldenstrom's macroglobulinemia should be assessed for oral health in addition to the stage of hyperviscosity syndrome.