Risk factors for oral mucositis in paediatric oncology patients receiving alkylant chemotherapy

Abstract

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.

Oral Mucositis in Pediatric Acute Lymphoblastic Leukemia Patients: Evaluation of Microbiological and Hematological Factors

“…Patient age (p = 0.33) and gender (p = 0.08) showed no correlation with the oral mucositis occurrence [25]. Cheng et al [6,26], Fadda et al [27] and Otmani et al [9] also reported that no association was found between OM grades and age or gender in pediatric patients. These results are in agreement with our data.…”

Pretherapeutic Plasma Pro- and Anti- Inflammatory Mediators Are Related to High Risk of Oral Mucositis in Pediatric Patients with Acute Leukemia: A Prospective Cohort Study

“…Within studies on pediatric patients, parameters including body weight prior to chemotherapy [4], blood type [5], underlying malignant disease [6], specific chemotherapy regimens or protocols [7], [8], serum creatinine level [4], blood methotrexate concentration [9], and neutropenia [4], [10], [11] have been suggested as risk factors for developing oral mucositis. However, the relative contribution of these risk factors in relation to mucositis is not clear, which makes it difficult to identify the patients at a higher risk of oral mucositis.…”

Glutamine: Beneficial to prevent oral mucositis in Mexican children with acute lymphoblastic leukemia?

“…Numerous patient-related factors as the BMI may influence the risk of developing OM [31,32] . A poor nutritional status seems to interfere with mucosal regeneration by decreasing cellular migration and renewal [33] .…”