ABSTRACT
Chemotherapy-induced oral mucositis is a frequent therapeutic challenge in cancer patients. The purpose of this retrospective study was to estimate the prevalence and risk factors of oral mucositis in 169 acute lymphoblastic leukaemia (ALL) patients treated according to different chemotherapeutic trials at the Darcy Vargas Children's Hospital from 1994 to 2005. Demographic data, clinical history, chemotherapeutic treatment and patients' follow-up were recorded. The association of oral mucositis with age, gender, leucocyte counts at diagnosis and treatment was assessed by the chi-squared test and multivariate regression analysis. Seventy-seven ALL patients (46%) developed oral mucositis during the treatment. Patient age (P = 0.33), gender (P = 0.08) and leucocyte counts at diagnosis (P = 0.34) showed no correlation with the occurrence of oral mucositis. Multivariate regression analysis showed a significant risk for oral mucositis (P = 0.009) for ALL patients treated according to the ALL-BFM-95 protocol. These results strongly suggest the greater stomatotoxic effect of the ALL-BFM-95 trial when compared with Brazilian trials. We concluded that chemotherapy-induced oral mucositis should be systematically analysed prospectively in specialized centres for ALL treatment to establish the degree of toxicity of chemotherapeutic drugs and to improve the quality of life of patients based on more effective therapeutic and prophylactic approaches for prevention of its occurrence.
Subject(s)
Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology , Stomatitis/epidemiology , Adolescent , Age Factors , Antibiotics, Antineoplastic/administration & dosage , Antimetabolites, Antineoplastic/administration & dosage , Antineoplastic Agents/therapeutic use , Antineoplastic Agents, Alkylating/administration & dosage , Antineoplastic Agents, Hormonal/administration & dosage , Antineoplastic Agents, Phytogenic/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Asparaginase/therapeutic use , Brazil/epidemiology , Child , Child, Preschool , Cyclophosphamide/therapeutic use , Cytarabine/therapeutic use , Daunorubicin/therapeutic use , Female , Follow-Up Studies , Humans , Infant , Leukocyte Count , Male , Mercaptopurine/therapeutic use , Prednisolone/therapeutic use , Prevalence , Retrospective Studies , Risk Factors , Sex Factors , Vincristine/therapeutic useABSTRACT
Os autores estudaram experimentalmente três grupos de 12 disparos de armas de fogo calibre 38. O grupo 1 utilizou muniçao comum sem nenhum preparo e serviu como controle; no grupo 2, provocou-se contaminaçao da muniçao com bactérias de E. coli e S. aureus padronizadas; e no grupo 3, utilizou-se muniçao comum, mas transfixando tecido contaminado pelas mesmas bactérias. Nos grupos 1 e 2, nao foi observado crescimento bacteriano em nenhum meio de cultura, fortalecendo a hipótese da esterilizaçao do projétil pelo disparo. No grupo 3, houve crescimento bacteriano tanto num meio de cultura sólido quanto num líquido, demonstrando que um projétil se contamina ao atravessar tecido contaminado, carreando bactérias no seu trajeto.
