BackgroundWe describe the risk indicators for oral mucositis (OM) in paediatric oncology patients hospitalised in the Institut Gustave Roussy (Villejuif-Paris) and treated with alkylant chemotherapy with autologous peripheral blood progenitor cells.MethodsThe sample was selected using PIGAS software. Three groups of subjects received different chemotherapy regimens: A. Melphalan, B. Busulfan and C. other alkylant protocols. The degree of mucositis was recorded by CTC version 2.0 (Common Toxicity Criteria). Descriptive statistics were performed. The association between mucositis and risk indicator variables was tested using a χ2 test. The association between case status and covariates was tested using unconditional logistic regression analysis.ResultsOf the 337 children enrolled, 241 showed mucositis (group 1) and 96 did not show mucositis (group 2) during alkylant chemotherapy. There was a higher prevalence of male patients in both groups. The three different chemotherapy regimen groups are correlated with the appearance of oral mucositis (χ2 = 22.42, p < 0.01). Weight loss was higher in group 1 (χ2 = 6.31, p = 0.01). The duration of aplasia was lower in the Busulfan protocol (7.5 days) than in the Melphalan group (9.3 days) or the other regimens (8.6 days). The use of Bufulfan® was directly associated with case status (presence of oral mucositis): odds ratio [OR] = 2.1 and confidence interval [95%CI] = 1.3–3.0. Also, occurrences of germinal tumours and secondary bacterial infections were directly linked with case status: [OR] = 1.4 and 1.8, confidence interval [95%CI] = 1.2 – 1.7 and 1.1 – 2.5, respectively.ConclusionThe presence of OM was associated with the three different chemotherapy regimens considered; in particularly patients treated with Busulfan had the highest prevalence.
Our data failed to demonstrate the association between periodontitis and an adverse pregnancy outcome such as preterm birth, low birth weight, preeclampsia, intrauterine growth restriction, and premature rupture of membranes.
The purpose of this investigation was to determine the oral status in a group of patients with thalassemia major (TM). Eighteen TM patients (15 M, three F) and 18 healthy controls randomly matched for age and sex were examined for dental caries using the decayed, missing, and filled teeth (DMFT) index and for oral hygiene conditions using the oral hygiene index (OHI)-S. Spontaneous saliva was collected from each subject, and the biochemical composition (calcium, phosphorous, potassium, sodium, urea) was determined. Furthermore, salivary Streptococcus mutans levels were evaluated. Statistical analysis (Student's t-test) were performed for means comparison, while independence among categorical variables was assessed using the chi(2) test. Fisher's exact test was used when expected cell values were less than 5. Dental status (DMFT index) was almost equal in the two groups (10.3 in TM vs 9.4 in controls, P=0.34). The occurrence of plaque (OHI-S 2) was higher in the control group, but no statistically significant association was observed between oral hygiene conditions in the two groups (Fisher's exact test 0.47, P=0.79). Biochemical saliva composition was very similar in the two groups; only the urea concentration was lower in TM, and this difference was statistically significant ( P=0.002). The TM patients had an increased presence of mutans streptococci at detectable levels. Our findings confirm that, although no substantial differences were found between the two observed groups, further investigations are needed to determine the theoretical risk of oral diseases in thalassemic patients.
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