Prevalence and Risk Factors of Chemotherapy-Induced Oral Mucositis in 470 Children With Acute Lymphoblastic Leukemia.

Abstract

Objective: To assess the prevalence and risk factors of chemotherapy-induced oral mucositis in 470 children with acute lymphoblastic leukemia in China, focusing on treatment-related risk factors.

Methods: This cross-sectional study included 470 children diagnosed with acute lymphoblastic leukemia in China from January 2020 to July 2022. Data were collected from electronic medical records, field investigations, and telephone follow-ups, covering sociodemographic characteristics, nutritional status, disease and treatment history, and microbiological factors. Univariate and multivariate logistic analyses were used to evaluate the association between the occurrence and severity of chemotherapy-induced oral mucositis and these variables.

Results: The prevalence of chemotherapy-induced oral mucositis was 45.1%. Significant risk factors included receiving more than five chemotherapy cycles (p < 0.001), carrying HSV-1 (p = 0.016), infection with Candida albicans (p = 0.012), undergoing chemotherapy with specific drugs containing methotrexate/daunorubicin/cytarabine (p < 0.001), having a high clinical risk stratification (p = 0.002), and being over 6 years old (p = 0.002). The severity of chemotherapy-induced oral mucositis was associated with consolidation and intensification period (p = 0.001) and B-cell immune stratification (p < 0.001).

Conclusion: The prevalence of chemotherapy-induced oral mucositis in children with acute lymphoblastic leukemia is relatively high. It emphasizes the importance of clinical medical staff paying attention to this issue and adopting targeted interventions to reduce the prevalence of oral mucositis in this patient population.