EFFECTIVENESS OF LOCAL IMMUNOMODULATORY THERAPY IN PATIENTS WITH CHRONIC PERIODONTITIS AND LEUKEMIA: A CLINICAL AND LABORATORY STUDY
Abstract
Chronic leukemia significantly worsens periodontal disease outcomes, leading to higher rates of severe periodontitis and poor response to standard treatments. This study evaluated a novel adjunctive local immunomodulatory therapy in 62 patients with chronic leukemia and periodontitis (main group) compared to 63 similar patients receiving standard care alone (comparison group). All patients underwent baseline clinical assessment (periodontal indices, probing depth, bleeding) and laboratory evaluation (salivary IgA, IgM, IgG, lysozyme). The main group received a 14-day course of a local immunomodulator (Ventero-Nova) applied to the gingiva alongside conventional scaling and antiseptics, while the comparison group received only standard therapy. Results: At baseline, leukemia patients exhibited pervasive periodontal inflammation and immune dysfunction: mean Papillary-Marginal-Alveolar (PMA) inflammation index ~85% vs 21% in controls, with bleeding on probing ~70% vs 18%. Salivary immune factors were significantly reduced: IgA ~35% below normal (128 vs 197 μg/mL) and lysozyme ~45% below normal (0.73 vs 1.31 U/mL, p<0.001). Standard therapy alone provided only transient improvement, with literature indicating up to 60% recurrence of inflammation by 3 months and persistent deep pockets in leukemia patients. In contrast, the adjunctive immunotherapy group achieved significantly better outcomes. By 90 days, the main group showed a 44.1±5.2% reduction in PMA index, a mean probing depth decrease of 1.6±0.3 mm, and an average reduction in total subgingival microbial load by 2.5 log₁₀ CFU/mL relative to baseline, all significantly greater improvements than in the comparison group (p<0.001). Salivary IgA levels in the main group rose from 128 to 177 μg/mL (~90% of healthy level), and lysozyme normalized (0.72 to 1.20 U/mL) by day 90. Concurrently, 71% of main-group patients achieved complete elimination of P. gingivalis from periodontal pockets. The comparison group, lacking immunotherapy, showed minimal immune improvement and more frequent disease relapse (persistent bleeding, recurrent deep pockets). No adverse effects of the immunomodulator were observed. Conclusions: Integrating local immunomodulatory therapy significantly enhanced clinical and immunological outcomes in leukemia patients with periodontitis. The approach restored mucosal immunity (IgA, lysozyme) and improved infection control, yielding a stable remission of periodontal disease. These findings underscore the efficacy and safety of adjunctive immunomodulation (e.g. Ventero-Nova) in managing periodontitis under immunocompromised conditions, consistent with prior reports on immunotherapy in periodontics. This strategy can be recommended to improve long-term periodontal health in hematological patients.
References
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