ABSTRACT
Statement of the Problem: Over the past three decades, significant improvements have been achieved in the survival of children with cancer. However, the considerable morbidity which occurs as a result of chemotherapy often restricts the treatment intensity. One of the important dose-limiting and costly adverse effects of cancer therapy is mucositis. Children with hematological malignancies are greatly at risk of developing mucositis
Purpose: This study aimed to assess the effectiveness of palifermin in preventing mucositis in children with acute lymphocytic leukemia [ALL] who undergo chemotherapy
Materials and Method: In this clinical trial, 90 children with ALL were randomized to receive chlorhexidine [n=45] or palifermin [n=45]. One group received 60 micro g/ kg/ day palifermin as an intravenous bolus once daily for 3 days before and 3 days after the chemotherapy. Chlorhexidine mouthwash was administered once daily for 3 days before and 3 days after the chemotherapy. The world health organization [WHO] oral toxicity scale was employed for grading the mucositis. The data were analyzed by using two-way ANOVA
Results: The two groups were matched for age and gender. The study groups were significantly different in terms of mucositis grading [P values after 1 and 2 week therapy were 0.00]. Palifermin decreased the incidence and severity of chemotherapy-induced mucositis
Conclusion: Palifermin reduces the oral mucositis in children with ALL. Several mechanisms of action are suggested for keratinocyte growth factor [such as palifermin] including promotion of cell proliferation and cytoprotection, restraining the apoptosis, and changing the cytokine profile