Fatores de risco para mucosite bucal em pacientes com leucemia linfóide aguda submetidos a diferentes protocolos de tratamento / Risk factors to oral mucositis in patients with acute limphoblastic leukemia submitted to different treatment protocols

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

Oral mucositis is one of the main complications secondary to antineoplastic treatment in patients with acute lymphoblastic leukemia (ALL). The risk factors for its occurrence include age, gender and initial leukocyte count, besides chemotherapeutic drugs with known stomatotoxic action. This study investigated the prevalence and risk factors to oral mucositis in patients with ALL submitted to different chemotherapeutic treatment protocols. A total of 169 clinical records of pediatric oncology patients submitted to different treatment protocols for ALL at the Pediatric Oncology Sector of the Child Hospital Darcy Vargas, in the city of São Paulo, in the period 1994 to 2005 were retrospectively evaluated. Demographic (age and gender) and clinical data (initial leukocyte count, treatment protocol adopted, evolution, occurrence of mucositis and other oral lesions) were recorded. The association of oral mucositis with the clinical and demographic variables was assessed by the chi-square test and multivariate logistic regression analysis. The results demonstrated occurrence of oral mucositis in 46% of pediatric oncology patients with ALL, without statistically significant correlation between its occurrence and gender (p=0.08), age (p=0.33) and initial leukocyte count (p=0.34). Multivariate analysis revealed that the Berlin-Frankfurt-Munich protocol of 1995 (ALL-BFM 95) was the most significant factor (p=0.009) to the occurrence of oral mucositis according to the variables evaluated in this study. These results strongly suggest the greater stomatotoxic effect of the ALL-BFM 95 protocol, as demonstrated by the higher frequency of oral mucositis in pediatric oncology patients with ALL. Thus, it may be concluded that oral mucositis should be systematically analyzed in centers specialized in the treatment of ALL adopting different treatment protocols, with a view to contribute to analysis of the degree of toxicity of chemotherapeutic drugs and mainly to improve the quality of life of patients on the basis of more effective therapeutic and prophylactic approaches for prevention of its occurrence.

ASSUNTO(S)

leucemia linfóide aguda criança mucositis children quimioterapia chemotherapy mucosite acute lymphoblastic leukemia

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