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LETTERS TO THE EDITORTurk J Hematol 2018;35:75-93AcknowledgmentThe authors would like to thank Ankaferd Pharmaceuticals forproviding the study drugs and Dr. İbrahim Haznedaroğlu for hiscritical review of the manuscript.Keywords: Childhood cancers, Oral mucositis, AnkaferdBloodStopper, CitrullineAnahtar Sözcükler: Çocukluk çağı kanserleri, Oral mukozit,Ankaferd BloodStopper, SitrülinConflict of Interest: The authors of this paper have no conflictsof interest, including specific financial interests, relationships,and/or affiliations relevant to the subject matter or materialsincluded.References1. Bonnaure-Mallet M, Bunetel L, Tricot-Doleux S, Guérin J, Bergeron C, LeGallE. Oral complications during treatment of malignant diseases in childhood:effects of tooth brushing. Eur J Cancer 1998;34:1588-1591.2. Bilgili H, Kosar A, Kurt M, Onal IK, Goker H, Captug O, Shorbagi A, Turgut M,Kekilli M, Kurt OK, Kirazli S, Aksu S, Haznedaroglu IC. Hemostatic efficacyof Ankaferd Blood Stopper in a swine bleeding model. Med Princ Pract2009;18:165-169.3. Koçak E, Akbal E, Taş A, Köklü S, Karaca G, Can M, Kösem B, Üstün H. Antiinflammatoryefficiency of Ankaferd blood stopper in experimental distalcolitis model. Saudi J Gastroenterol 2013;19:126-130.4. Saribas Z, Sener B, Haznedaroglu IC, Hascelik G, Kirazli S, Goker H.Antimi¬crobial activity of Ankaferd BloodStopper® against nosocomialbacterial pathogens. Cen¬tral Eur J Med 2010;5:198-202.5. Ciftci S, Keskin F, Keceli Ozcan S, Erdem MA, Cankaya B, Bingol R, KasapogluC. In vitro antifungal activity of Ankaferd BloodStopper against Candidaalbicans. Curr Ther Res Clin Exp 2011;72:120-126.Address for Correspondence/Yazışma Adresi: Nagihan ERDOĞ ŞAHİN, M.D.,Erciyes University Faculty of Medicine, Department of Pediatrics, Kayseri, TurkeyPhone : +90 232 250 50 50E-mail : dr.nagihansahin@yahoo.com ORCID-ID: orcid.org/0000-0002-7144-064XReceived/Geliş tarihi: August 25, 2017Accepted/Kabul tarihi: November 20, 2017DOI: 10.4274/tjh.2017.032086
Turk J Hematol 2018;35:75-93LETTERS TO THE EDITORLate Side Effects of Chemotherapy and Radiotherapy in EarlyChildhood on the Teeth: Two Case ReportsErken Çocukluk Döneminde Alınan Radyoterapi ve Kemoterapinin Dişler Üzerine Geç DönemEtkileri: İki Olgu SunumuSevcihan Günen Yılmaz 1 , İbrahim Şevki Bayrakdar 2 , Seval Bayrak 3 , Yasin Yaşa 41Akdeniz University Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Antalya, Turkey2Eskişehir Osmangazi University Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Eskişehir, Turkey3Abant İzzet Baysal University Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Bolu, Turkey4Ordu University Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Ordu, TurkeyTo the Editor,Radiotherapy and chemotherapy can generate adverse resultsduring or after the completion of therapy and these treatmentscan also cause some oral anomalies [1,2,3]. Early and late oraldentalabnormalities have been reported in head and neck cancerpatients treated with radiotherapy and chemotherapy. The lateside effects of chemotherapy and radiotherapy on the permanentteeth of two patients who had cancer treatment in their earlychildhood periods are presented here.Radiotherapy and chemotherapy, which are the main treatmentsof cancer for young children, can have long-term adverse effectspertaining to the growth and development of orofacial and dentalstructures.Case 1: According to the medical history of a 17-year-old femalepatient who applied to our clinic for routine dental treatment,she had received radiotherapy and chemotherapy due to havingHodgkin lymphoma between the ages of 4 and 5. At the age of 4years, the patient was admitted to the hospital with an early stageof Hodgkin lymphoma and 4 cycles of the adriamycin, bleomycin,vinblastine, dacarbazine (ABVD) chemotherapy protocol and 20 Gyof neck-region radiotherapy were applied. Complete remission wasobtained.In the oral and radiographic examinations, microdontia was foundin teeth 11, 15, 17, 21, 25, 36, and 46. The root formations of theseteeth were less developed. Due to the lack of germ of teeth 26, 27,37, and 47, hypodontia was found (Figure 1A). The unstimulatedsalivary rate was low (0.3 mL/min). The mouth opening was normal.Case 2: According to the medical history of a 24-year-old malepatient who applied to our clinic for routine dental treatment, sixcycles of ABVD chemotherapy protocol and 30 Gy of radiotherapyto the neck region had been given due to diagnosis of stage IIIHodgkin lymphoma between the ages of 7 and 9 years old.Complete remission was achieved.In oral and radiographic examinations, microdontia was found inteeth 34, 35, 37, 44, 45, 47, and 48 (Figure 1B). The root formationsof these teeth were less developed. The unstimulated salivary ratewas low (0.3 mL/min). The mouth opening was normal.Figure 1. A) Panoramic radiography of case 1; B) panoramicradiography of case 2. A) Panoramic radiography of case 1; B)panoramic radiography of case 2.87
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