Continuing Challenges and Current Issues of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia: Case Report

Abstract

Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy, accounting for nearly 75% of all newly diagnosed leukemias and 25% of all malignancies in childhood. The Philadelphia chromosome-positive Ph+ is a rare subtype of ALL, considered one of its poorest subgroups, and accounts for 3-5% of pediatric ALL. Dentists should acquire some background information about leukemia and its oral manifestations for better dental care. Commonly reported oral manifestations include regional lymphadenopathy, mucous membrane petechiae and ecchymoses, gingival bleeding, gingival hypertrophy, pallor, and non-specific ulcerations. In this case report, we aim to raise awareness among dentists and discuss the orthodontic management of a pediatric patient with Ph+ ALL. The patient was cleared by her treating physician, and treatment was done in the dental chair. Treatment included restorations of all carious teeth, reinforcement of oral hygiene, a series of removable appliances to correct the anterior cross-bite, and in-office bleaching.