CLINICAL AND LABORATORY BASIS FOR THE USE OF EFFERENT THERAPY (ILBI) IN IMPROVING THE FUNCTIONAL STATE OF PERIODONTAL TISSUES IN PATIENTS WITH CHRONIC LEUKEMIA

Chronic leukemia is associated with profound immune dysfunction, microcirculatory disorders, thrombocytopenia, and granulocytopenia, which collectively lead to severe, rapidly progressive, and treatment-resistant periodontitis. Efferent therapy methods, particularly intravenous laser blood irradiation (ILBI), have emerged as promising adjunctive modalities for managing periodontal disease in this vulnerable patient population. This literature review analyzes the clinical and laboratory basis for the use of ILBI (VLOK therapy) in improving the functional state of periodontal tissues in patients with chronic leukemia. The key mechanisms of action include immunomodulation (normalization of immunoglobulin levels, reduction of proinflammatory cytokines), improvement of blood rheology and microcirculation, antioxidant effects, antimicrobial activity, and stimulation of reparative processes in periodontal tissues. Clinical studies demonstrate that ILBI significantly reduces gingival bleeding (BOP reduction by 4.8-fold), decreases periodontal pocket depth, increases salivary flow rate (from 0.127 to 0.28 mL/min), normalizes IgG and IgE levels (29.3% increase and 79.9% reduction respectively), suppresses proinflammatory cytokines (4.4–4.7-fold reduction), and reduces periodontopathogen load (63.6% reduction for T. denticola, 57.0% for A. actinomycetemcomitans). The evidence supports the integration of ILBI into comprehensive periodontal treatment protocols for chronic leukemia patients as a safe, pathogenetically justified, and clinically effective efferent therapy modality.