title: Oral Mucositis in Pediatric Acute Lymphoblastic Leukemia Patients: Evaluation of Microbiological and Hematological Factors.
abstract: OBJECTIVE
  to investigate the associations of oral microbiota, leucocytes count, neutrophil count, platelet counts and hemoglobin level, and the severity of oral mucositis in pediatric patients with acute lymphoblastic leukemia (ALL) receiving chemotherapy.
  
  
  METHODS
  71 prospective patients were included. Analyses of oral microbiota and blood sample 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
  103 episodes of mucositis occurred, being 65 at D14 and 38 at D56. Most cases positive for herpes viral DNA sequences were identified as HSV-1. At D14, we found a significant association between the severity of mucositis and presence of HSV-1 (p = 0.0347), Candida spp. (p = 0.0078), and low platelet count (p = 0.0064). At D56, we found a significant association between the severity of mucositis and the presence of HSV-1 (p = 0.0317), previous HSV-1 presence on D14 (p < 0.0001) and neutrophil count (p = 0.0211).
  
  
  CONCLUSIONS
  the identification of risk factors for mucositis in children and adolescents may contribute to the development of new strategies for prevention and/or treatment, reducing the complications associated with this condition.
  
  
  CONCLUSIONS
  the presence of HSV, platelet count, and Candida spp. presence at D14 of ALL induction treatment is associated with increased severity of mucositis in children and adolescents. At D56 of ALL treatment, mucositis severity was associated with neutrophil count, HSV presence, and previous presence of HSV (at D14).
authors.affiliation: Centro Infantil Boldrini; Universidade Estadual de Campinas , Campinas, SP , Brazil.
authors.forename: Regina Maria Holanda de
authors.initials: RM
authors.lastname: Mendonça
authors.forename: Marcela de
authors.initials: Md
authors.lastname: Araújo
authors.forename: Carlos Emilio
authors.initials: CE
authors.lastname: Levy
authors.forename: Joseane
authors.initials: J
authors.lastname: Morari
authors.forename: Rosângela A
authors.initials: RA
authors.lastname: Silva
authors.forename: José Andres
authors.initials: JA
authors.lastname: Yunes
authors.forename: Silvia Regina
authors.initials: SR
authors.lastname: Brandalise
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001938:Brazil / Q000453:epidemiology; D002175:Candida; D002177:Candidiasis / Q000139:chemically induced / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006561:Herpes Simplex / Q000139:chemically induced / Q000453:epidemiology*; D018259:Herpesvirus 1, Human; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000453:epidemiology; D011446:Prospective Studies; D013280:Stomatitis / Q000139:chemically induced / Q000453:epidemiology*
keywords: acute lymphoblastic leukemia; candida spp; hematological parameters; herpes virus; oral bacteria; oral mucositis