title: Prospective evaluation of HSV, Candida spp., and oral bacteria on the severity of oral mucositis in pediatric acute lymphoblastic leukemia.
abstract: BACKGROUND
  Oral mucositis is a common collateral effect among the secondary complications resulting from chemotherapy. The objective of this study was to prospectively evaluate the association of HSV-1, Candida spp., and oral bacteria on the severity of oral mucositis in pediatric acute lymphoblastic leukemia (ALL).
  
  
  METHODS
  Seventy-one prospective patients were included. Analyses of oral microbiota were conducted on days 14 (D14) and 56 (D56) of the Brazilian GBTLI-99 treatment protocol. Herpes simplex virus (HSV) identification was performed by PCR followed by DNA sequencing analysis. Bacteria and fungi identification was obtained by standard microbiological culture tests.
  
  
  RESULTS
  HSV-1 was found in 10.37% of individual patient samples. One sample was positive for HSV-4. On D14, we found an association between the severity of mucositis and the presence of HSV (p = 0.0347) and Candida spp. (p = 0.0078). At D56, we found an association between the severity of mucositis and the presence of HSV on D14 (p < 0.0001) and HSV presence (p = 0.0317).
  
  
  CONCLUSIONS
  The presence of HSV, mainly HSV-1, and Candida spp. was associated with mucositis severity in pediatric ALL. No association could be found between bacterial CFU and severity of mucositis.
authors: Unidade de Odontologia, Centro Infantil Boldrini, Campinas, SP, Brazil. reginamhm@gmail.com
authors: Regina Maria Holanda
authors: RM
authors: de Mendonça
authors: Marcela
authors: M
authors: de Araújo
authors: Carlos Emilio
authors: CE
authors: Levy
authors: Joseane
authors: J
authors: Morari
authors: Rosângela A
authors: RA
authors: Silva
authors: José Andres
authors: JA
authors: Yunes
authors: Silvia Regina
authors: SR
authors: Brandalise
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