The Impact of Prophylactic Photobiomodulation Therapy on Reducing Oral Mucositis in Patients with Leukemia: A Narrative Review

Abstract

Background and Objective: Leukemia is a malignant neoplasm characterized by disordered proliferation of blood cells originating in the bone marrow and lymphoid tissues. It can be classified into several subtypes; the four principal ones are acute myeloid leukemia (AML), chronic myeloid leukemia (CML), acute lymphoblastic leukemia (ALL), and chronic lymphoblastic leukemia (CLL). During antineoplastic therapy, the oral cavity is frequently affected because the drugs used cause tissue damage, stimulating the release of inflammatory cytokines and favoring the development of ulcerated and erythematous lesions. Among these manifestations, oral mucositis (OM) stands out as one of the most common and painful complications, significantly impacting patients’ quality of life. OM is also a major dose-limiting factor and may lead to treatment interruption. Low-level laser therapy (LLLT), in turn, acts through photophysical and biochemical mechanisms that enhance cellular metabolism, stimulate mitochondrial activity, and exert analgesic, anti-inflammatory, and reparative effects on the mucosa. Thus, it represents an effective preventive measure with positive clinical results and is well-tolerated, non-toxic, and free of side effects. This study aimed to conduct a literature review on the impact of prophylactic laser therapy in reducing this condition. Materials and Methods: A literature search was conducted in PubMed and SciELO for articles published between 2020 and 2025. Boolean operators (AND, OR) were utilized to combine descriptors including “Low-Level Laser Therapy”, “Oral Mucositis”, and “Leukemia”. The method included inclusion/exclusion criteria and search strategies. Results: Forty-three articles were initially identified, and after applying strict inclusion/exclusion criteria, twenty-five studies were selected for narrative synthesis. Conclusion: This review allows us to conclude that using laser therapy in leukemia patients undergoing antineoplastic treatment is a relevant strategy to prevent OM.

Clinical application: The benefits include longer survival, pain relief and control, shorter hospital stays, and improved quality of life. Regarding protocols, there is no standardization of preventive strategies, as application parameters may vary among professionals. However, the literature is generally consistent that – regardless of the technique employed – low-level laser therapy is effective in reducing OM.