Evaluation of Gingival Conditions and Saliva TNF-α Concentration in Children with Acute Lymphoblastic Leukemia

Abstract

Introduction.Patients with the history of neoplastic disease in childhood and adolescence, successfully treated, are at higher risk in terms of their susceptibility to develop other diseases later in their lives.Aim. The purpose of study was to evaluate saliva TNF-α concentration in the children with acute lymphoblastic leukemia with reference to gingival inflammations.Material and methods. The investigation was carried out in the group of 78 children with ALL aged 2-18yrs and analogical in terms of age and gender group of healthy controls. Results. Gingival conditions were expressed as gingival index (GI). In the group of children with ALL mean GI determined in examination 1 was 0.084±0.34, in examination 2 GI=0.007±0.04 and in examination 3 mean GI=0.017±0.13. In the group of healthy controls GI=0.003±0.03. Saliva concentration of TNF-α determined in the group of children with ALL in examination 1 ranged 4.16-135.01pg/ml. In that group in examination 1, mean saliva TNF-α concentration was 36.9±32.6pg/ml. In the group of healthy children mean saliva TNF-α concentration was 52.1±107.64pg/ml.Conclusions. The authors, who observed various increases in the concentrations of TNF-α, IL-1α, IL-6, and IL-8 in the saliva and oral tissues in the patients consider that the proinflammatory cytokines in the saliva present in significantly higher concentrations in the future may have diagnostic and predicative value as replace indices of neoplastic transformations.Monitoring of prognostic factors affecting inflammations of the oral mucosa in children with ALL is likely to prevent complications to standard treatment and prolonged time of anticancer therapy. Early evaluation of those parameters can quicken recovery and strengthen patient's health. Close cooperation between dentists and pediatricians-hematologists is important in maintaining oral health and improve the quality of life of children suffering from neoplastic diseases.

Oral mucositis and saliva IgA, IgG and IgM concentration during anti-tumor treatment in children suffering from acute lymphoblastic leukemia

“…8,18 In my own previous studies, decreases in salivary TNF-α and IL-2 was observed in patients with ALL as compared to healthy children. 25,26 In an effort to minimize the side effects of radiation therapy and chemotherapy used in cancer treatment, there have been studies aimed at developing therapeutic strategies to regenerate oral mucosal tissues affected by mucositis. 3,5 Certain agents have been examined for prevention or treatment of oral mucositis caused by chemotherapy or radiotherapy, but none of them has been confirmed as fully effective.…”