Etiology • Unknown • Probably multifactorial: genomic instability including genetic
predisposition, syndromic association, prior chemotherapy, environmental factors
Clinical Presentation • Oral expression most common with myelomonocytic and mye-
locytic forms, followed by lymphocytic form • Petechiae, ecchymosis • Spontaneous gingival hemorrhage • Mucosal ulceration (neutropenic ulcers) • Cervical lymphadenopathy • Loose teeth (due to infiltration of periodontal ligament)
predisposition, syndromic association, prior chemotherapy, environmental factors
Clinical Presentation • Oral expression most common with myelomonocytic and mye-
locytic forms, followed by lymphocytic form • Petechiae, ecchymosis • Spontaneous gingival hemorrhage • Mucosal ulceration (neutropenic ulcers) • Cervical lymphadenopathy • Loose teeth (due to infiltration of periodontal ligament)
Radiographic Findings • Osteolytic lesions in up to one-half of childhood cases • Expanded, coarse marrow spaces and trabeculae • Alveolar bone destruction • Loss of lamina dura and border of developmental dental crypts • Periosteal reaction with “onion skin” effect
Diagnosis • Peripheral blood analysis • Bone marrow biopsy analysis
Differential Diagnosis • Medication-induced gingival hyperplasia • Idiopathic thrombocytopenia • Lymphoma
Treatment • Chemotherapy regimen(s)—these vary with form of disease • Bone marrow transplantation
Prognosis • Varies with form of disease and response to treatment