2002 Volume 51 Issue 4 Pages 256-260
This study was carried out to retrospectively investigate the safety for infection after dental extractions in neutropenic patients with hematological diseases. The subjects were 19 patients, consisting of 5 male and 14 female, ranging in age from 20 to 74 years, with a mean of 49.7 years old. The hematological diseases were 6 cases of aplastic anemia, 5 of acute myeloid leukemia, 3 of myelodysplastic syndrome, 2 of acute lymphatic leukemia, and 1 each of autoimmunoneutropenia, multiple myeloma, and chronic myeloid leukemia. Granulocyte colonystimulating factor (G-CSF) was administered to 9 patients aiming to increase the neutrophil count. The neutrophil count increased after the treatment with G-CSF in 6 patients, but it was unchanged in 3 that had counts of less than 100/μl at the initial visit. Ten patients were not given G-CSF because of the condition of their diseases. Thirty teeth were removed, to prevent them from infection after bone marrow transplant or chemotherapy, under medication of β-lactam antibiotics. Infection of the extraction site occurred in 2 patients, in whom the neutrophil count was less than 120/μl at the time of extraction, regardless of administration of G-CSF. The 2 patients were successfully treated with administration of broad-spectrum antibiotics. These results suggested that dental extraction is safe in most neutropenic patients with hematological diseases but has a risk of local infection in patients with neutrophil counts of less than 120/μl.
