Chemotherapy: Open Access
Open Access

Abstract

Concentration of Tumour Necrosis Factor-Alpha in Saliva of Patients with Acute Lymphoblastic Leukaemia in Relation to Oral Mucositis during Chemotherapy

Elżbieta Pels

Abstract Purpose: Ulceration in the oral cavity caused by stomatotoxic chemotherapy is painful and restricts oral administration of drugs. The study objective was to assess concentration of tumour necrosis factor-alpha (TNF-?) cytokine in saliva of patients with acute lymphoblastic leukaemia and to assess the occurrence of oral mucositis during chemotherapy. Methods: The study included 78 children with ALL in followed three examinations and a control group - 78 healthy children. In the group of patients with ALL was conducted the clinical study to assess oral mucosa based on the five-grade WHO classification of oral mucositis. Two hours after morning meal unstimulated saliva samples were taken and TNF-? was determined by TNF-? human EIA Results: Saliva TNF-? concentration determined in the group of children with ALL in examination 1 ranged 4.16?135.01pg/ml. Mean saliva TNF-? concentration was 28.2�20.4pg/ml in examination 2, and 28.9�28.8pg/ml in examination 3. In the group of children with ALL mean saliva TNF-? values were lower compared to the control group. Lesions of the mucositis type were observed in ALL children in the period from 48 hours to 6 months, having various intensity and with periods without pathological lesions, which was related to the intensity of the chemotherapy ? examination 2. Conclusions: Disorders in the immune system during chemotherapy may cause increase in pathological changes of oral mucosa. Early assessment of proinflammatory cytokines may prevent complications of standard treatment and prolongation of anti-tumour treatment, which will allow fast recovery of patients with ALL.