Oral mucositis and saliva IgA, IgG and IgM concentration during anti-tumor treatment in children suffering from acute lymphoblastic Leukemia

Abstract

Background. Oral mucositis is a problem occurring within the oral cavity, which is the most difficult to deal with during anti-tumor treatment. The first symptom reported by the patient is discomfort. Salivary immunoglobulins play an important role in pathological processes occurring in the oral cavity. Objectives. The study objective was to assess the occurrence of oral mucositis and to assess changes in the saliva IgA, IgG, and IgM concentration in children with acute lymphoblastic leukemia during anti-tumor treatment. Material and methods. The study included 78 children with acute lymphoblastic leukemia (ALL) and a control group of healthy children. All the participants underwent 3 examinations. Results. Mucosal opacity followed by redness usually occurred within 2–4 days after the methotrexate infusion. The most severe lesions of the oral mucosa were observed after the 1st month of chemotherapy. Correlations were found between hard-to-heal wounds and ulcers and blood morphology parameters. The mean saliva IgA concentration in children with ALL during chemotherapy was significantly lower than in children in the control group. A comparison of the mean saliva IgG in a given patient in subsequent examinations revealed a significant saliva IgG decrease occurring between the 1st and 3rd examinations. Conclusions. Wounds and ulcers that were difficult to heal were related to blood morphology parameters. A low salivary IgA concentration in children with ALL may result in the development and potentiation of oral lesions typical of mucositis during anti-tumor treatment. A significant decrease in salivary IgG and IgM concentrations in children with ALL during chemotherapy may cause potentiation of pathological lesions in the oral mucosa.