Comparative Analysis of Chemotherapy-Induced Oral Mucositis, Nutritional Status, and Depression in Patients With Acute Leukemia

Abstract

Background: Chemotherapy, a fundamental treatment modality for acute leukemia, is linked to significant adverse effects such as oral mucositis, nutritional decline, and depression, all of which markedly impact patient outcomes.

Objective: This study aimed to evaluate the progression of chemotherapy-induced oral mucositis and its impact on nutritional status and depression in patients with acute leukemia.

Methods: In this prospective descriptive study, 123 patients aged 19–70 years diagnosed with acute leukemia were recruited from a tertiary hospital through convenience sampling. These patients were scheduled for remission-induction, consolidation, or reinduction chemotherapy. Initially, 140 patients were enrolled, with 123 participants included in the final analysis after accounting for incomplete responses and dropouts. Oral mucositis, nutritional status, and depression were assessed using validated scales, with follow-up evaluations conducted 10 days post-chemotherapy. Oral mucositis was assessed using the WHO Mucositis Grading Scale, symptom experiences were measured with the MD Anderson Symptom Inventory, nutritional status was evaluated with the Patient-Generated Subjective Global Assessment (PG-SGA), and depression was assessed using the 10-item Center for Epidemiological Studies Depression Scale (CES-D-10). Statistical analyses included paired t-tests, ANOVA, and multiple regression.

Results: Compared to baseline, all the variables evaluated—oral mucositis, symptoms experiences, nutritional status, and depression—were significantly worsened on day 10 after chemotherapy. Regression analysis identified muscle weakness and skin problems as significant factors of depression. Additionally, patients receiving remission-induction therapy presented significantly worse depression than those receiving consolidation therapy.

Conclusion: This study highlighted the rapid deterioration of symptoms after chemotherapy in patients with acute leukemia. This underscores the need for a multidisciplinary approach that emphasizes nutritional support, emotional support, and evidence-based nursing interventions tailored to specific groups of symptoms. Future research should explore the educational interventions delivered during initial hospitalization and their effectiveness, particularly in patients receiving remission-induction therapy.