title: 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.
abstract: OBJECTIVE
  This prospective study evaluated clinical risk indicators as well as pro- and anti- inflammatory mediators at the time of malignancy diagnosis in relation to chemotherapy-related oral mucositis in pediatric population.
  
  
  METHODS
  Patients (n = 104) under 18 years of age with primary malignancies and undergoing chemotherapy were included. Potential risk indicators were analyzed using binary logistic regression with oral mucositis as the outcome. In a subgroup (n = 35), plasma samples at the time of malignancy diagnosis were analyzed for inflammatory cytokines and an antimicrobial protein pro-LL-37 (hCAP18).
  
  
  RESULTS
  In the multivariable model, type of malignancy diagnosis was significantly associated with oral mucositis, with highest risk of oral mucositis in patients with acute leukemia compared to those with lymphoma or solid tumors. At the time of malignancy diagnosis, plasma from patients with acute leukemia displayed higher concentrations (P<0.05) of IL-6, IL-8, IL-10, and TNF-α and lower levels of pro-LL-37 (P<0.001).
  
  
  CONCLUSIONS
  The results imply that pretherapeutic high levels of inflammatory cytokines and low levels of pro-LL-37 in plasma might contribute to the high incidence of oral mucositis in patients with acute leukemia. These findings may add to our understanding of the predispositions to oral mucositis in children with malignancies.
authors.affiliation: Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden. ying.ye@ki.se
authors.forename: Ying
authors.initials: Y
authors.lastname: Ye
authors.forename: Göran
authors.initials: G
authors.lastname: Carlsson
authors.forename: Monica Barr
authors.initials: MB
authors.lastname: Agholme
authors.forename: Jenny
authors.initials: J
authors.lastname: Karlsson-Sjöberg
authors.forename: Tülay
authors.initials: T
authors.lastname: Yucel-Lindberg
authors.forename: Katrin
authors.initials: K
authors.lastname: Pütsep
authors.forename: Thomas
authors.initials: T
authors.lastname: Modéer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood; D004198:Disease Susceptibility / Q000276:immunology; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000097:blood; D007223:Infant; D007231:Infant, Newborn; D018836:Inflammation Mediators / Q000097:blood*; D007938:Leukemia / Q000150:complications*; D008297:Male; D009369:Neoplasms / Q000150:complications; D011446:Prospective Studies; D012307:Risk Factors; D013280:Stomatitis / Q000097:blood* / Q000209:etiology*
chemical_list: D016207:Cytokines; D007155:Immunologic Factors; D018836:Inflammation Mediators