title: Prevention of oral lesions in children with acute lymphoblastic leukemia.
abstract: Acute lymphoblastic leukemia (ALL) is the most common form of cancer in children and is responsible for severe stomatologic complications. Treatment consists of four phases of chemotherapy, the main side effect of methotrexate, the drug most used during the intensification phase, is oral mucositis.
  
  
  OBJECTIVE
  To evaluate the clinical aspects of the oral mucosa of children with ALL and to determine the effect of 0.12% chlorhexidine gluconate on the prevention of stomatologic complications in these patients.
  
  
  METHODS
  Thirty-three children treated for ALL ranging in age from 2 to 15 years, without distinction of gender or race, were submitted to visual examination, digital palpation of the oral mucosa and cytologic examination of the buccal mucosa, and divided into two groups: group I consisted of 23 children using an oral solution of 0.12% chlorhexidine gluconate twice a day, and group II consisted of 10 children who did not receive this solution. All children received daily oral hygiene care guided by the dentist throughout treatment.
  
  
  RESULTS
  Mucositis was observed in six children of group I and eight of group II, and was characterized by erythema, edema and ulcers. Uniform cytologic findings were obtained for the two groups, with a clear predominance of cells of the intermediate layer in all smears, in addition to a perinuclear halo in 18% of the smears.
  
  
  CONCLUSIONS
  The present results suggest that systematic preventive treatment with 0.12% chlorhexidine gluconate and oral hygiene care reduce the occurrence of oral complications in children with ALL undergoing antineoplastic chemotherapy.
authors.affiliation: Department of Oral Pathology, School of Dentistry, Health Sciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil. leao@patologiaoral.com.br
authors.forename: Leão
authors.initials: L
authors.lastname: Pereira Pinto
authors.forename: Lélia Batista
authors.initials: LB
authors.lastname: de Souza
authors.forename: Manuel Antonio
authors.initials: MA
authors.lastname: Gordón-Núñez
authors.forename: Rosilene Calasanz
authors.initials: RC
authors.lastname: Soares
authors.forename: Edja Maria Melo
authors.initials: EM
authors.lastname: de Brito Costa
authors.forename: Ana Rafaela Luz
authors.initials: AR
authors.lastname: de Aquino
authors.forename: Maria Zélia
authors.initials: MZ
authors.lastname: Fernandes
mesh_terms: D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000009:adverse effects; D009061:Mouth Mucosa / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D013280:Stomatitis / Q000139:chemically induced / Q000473:pathology / Q000517:prevention & control*
chemical_list: D000890:Anti-Infective Agents; D000964:Antimetabolites, Antineoplastic; C010882:chlorhexidine gluconate; D002710:Chlorhexidine; D008727:Methotrexate