Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Seoul, Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Clin Exp Dent Res. 2020 Feb;6(1):90-99. doi: 10.1002/cre2.253. Epub 2019 Dec 9.
The objective of this study was to prospectively evaluate the clinical features of chemotherapy-induced oral mucositis (CIOM) in adult patients with acute leukemia and the aggravating factors for such symptoms.
Thirty-seven prospective patients aged ≥19 years with acute leukemia undergoing chemotherapy were enrolled. Oral and clinical investigations were performed at baseline and on Day 14 after starting chemotherapy. The presence and severity of cancer-induced oral mucositis were demonstrated using the World Health Organization (WHO) scoring system.
On Day 14, we found that oral mucositis had developed in eight patients (21.6%). Hematopoietic stem cell transplantation (HSCT) in patients was a predictor of increased WHO scores (β = 1.937, p < .001). Regarding oral sites, ventral tongue (β = 1.670), soft palate (β = 1.242), and buccal mucosa (β = 0.593) were predictors for increased scores. In addition, the increase in WHO scores was positively correlated with the number of oral lesions (r = .521), the difficulty in eating (r = .250), and the overall oral health (r = .534; all p < .05).
The main factors affecting the severity of CIOM symptoms were the treatment with HSCT and the location of oral lesions. The incidence of CIOM and WHO scores were not significantly different between the subgroups of disease. Our findings will help clinicians investigate the oral findings after chemotherapy in adult patients with acute leukemia.
本研究旨在前瞻性评估成人急性白血病患者化疗诱导性口腔黏膜炎（CIOM）的临床特征及加重症状的因素。
本研究纳入了 37 名年龄≥19 岁、接受化疗的急性白血病患者。在开始化疗前和第 14 天进行口腔和临床检查。采用世界卫生组织（WHO）评分系统评估癌症诱导性口腔黏膜炎的存在和严重程度。
第 14 天，我们发现 8 名患者（21.6%）出现口腔黏膜炎。造血干细胞移植（HSCT）是 WHO 评分增加的预测因素（β=1.937，p<.001）。对于口腔部位，舌腹（β=1.670）、软腭（β=1.242）和颊黏膜（β=0.593）是评分增加的预测因素。此外，WHO 评分的增加与口腔病变的数量呈正相关（r=.521）、进食困难呈正相关（r=.250），以及口腔整体健康状况呈正相关（r=.534；均 p<.05）。
影响 CIOM 症状严重程度的主要因素是 HSCT 治疗和口腔病变部位。疾病亚组之间 CIOM 的发生率和 WHO 评分无显著差异。我们的研究结果将有助于临床医生在急性白血病成年患者化疗后对口腔情况进行调查。
