与诊断为急性淋巴细胞白血病的儿童口腔黏膜炎的存在及严重程度相关的疱疹病毒血清阳性率。

Seroprevalence of herpes virus associated with the presence and severity of oral mucositis in children diagnosed with acute lymphoid leukemia.

作者信息

Santos de Faria Andreza Barkokebas, Silva Igor Henrique Moraes, de Godoy Almeida Roberta, Silva Sirleide Pereira da, Carvalho Alessandra Tavares, Leão Jair Carneiro

机构信息

Departamento de Clínicae Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, Brazil.

出版信息

J Oral Pathol Med. 2014 Apr;43(4):298-303. doi: 10.1111/jop.12138. Epub 2013 Dec 10.

DOI:10.1111/jop.12138

PMID:24325331

Abstract

INTRODUCTION

Acute lymphoid leukemia (ALL) is the hematologic neoplasia most commonly diagnosed in children. Among the secondary side effects of chemotherapy, mucositis is the most frequent complication. The aim of this study was to evaluate the seroprevalence of herpes viruses HSV-1, EBV, and CMV and the presence and severity of oral mucositis in children and adolescents diagnosed with ALL.

METHODOLOGY

Ninety-two patients diagnosed with ALL were evaluated. Serum samples were collected before chemotherapy and tested by ELISA method. Presence of mucositis was observed on the first day before antineoplastic therapy (D0) and on 7th day post-therapy (D7). Classification of mucositis intensity was performed according to toxicity criteria established by the National Cancer Institute.

RESULTS

70.7% of the patients presented mucositis on the D7, and of these, 60% were classified as Grade I and 40% as Grade II; of the 92 individuals tested, 59 (64.1%) presented antibodies for HSV-1, 57 (62%) for EBV, 75 (81.5%) for CMV_IgG, and 21 (22.8%) for CMV_IgM. Using a logistic regression model, the presence of HSV-1 was observed to be 4.10 times greater in Grade II mucositis severity than in Grade I (P = 0.03).

CONCLUSION

Based on the findings of this study, it was possible to conclude that infection by the herpes viruses HSV-1, EBV, and CMV is ubiquitous in the studied population and that HSV-1 may be a risk factor for aggravating the severity of mucositis.

摘要

引言

急性淋巴细胞白血病（ALL）是儿童中最常被诊断出的血液系统肿瘤。在化疗的继发副作用中，口腔黏膜炎是最常见的并发症。本研究的目的是评估单纯疱疹病毒1型（HSV-1）、EB病毒（EBV）和巨细胞病毒（CMV）的血清流行率，以及诊断为ALL的儿童和青少年口腔黏膜炎的存在情况和严重程度。

方法

对92例诊断为ALL的患者进行评估。在化疗前采集血清样本，并通过酶联免疫吸附测定（ELISA）法进行检测。在抗肿瘤治疗前第1天（D0）和治疗后第7天（D7）观察口腔黏膜炎的存在情况。根据美国国立癌症研究所制定的毒性标准对口腔黏膜炎强度进行分类。

结果

70.7%的患者在D7出现口腔黏膜炎，其中60%被分类为I级，40%为II级；在92名接受检测的个体中，59人（64.1%）出现HSV-1抗体，57人（62%）出现EBV抗体，75人（81.5%）出现CMV-IgG抗体，21人（22.8%）出现CMV-IgM抗体。使用逻辑回归模型观察到，II级口腔黏膜炎严重程度患者中HSV-1的出现率比I级高4.10倍（P = 0.03）。