Risk factors for oral mucositis in children undergoing chemotherapy: a matched case-control study

Oral mucositis (OM) is the most frequent and severe complication of chemotherapy for children with cancer, yet little is known about its risk factors. The aim of this study was to determine the risk factors associated with chemotherapy-induced OM in children. A matched case-control design was used. The matching criteria were age, type of cancer and chemotherapy regimen. Patient-and treatment-related data were collected via chart review. Conditional logistic regression analyses were performed to estimate odds ratios (OR) and adjusted odds ratios (AOR) for the development of OM. Fifty-one cases and 51 controls were identified. The mean+/-SD age of the children was 7.6+/-5.2 years, with 65 (63.73%) boys. Eighty-two percent of the children had been diagnosed with haematological malignancies (n=84). The most common chemotherapy regimen was a combination of plant alkaloids and antitumor antibiotics (n=42, 41.18%). In the multivariable model, lower body weight (AOR=0.91; 95% CI=0.84-0.98; p=0.013), lower value of log nadir neutrophil count (AOR=0.33; 95% CI=0.16-0.68; p=0.0025), and higher value of peak creatinine (AOR=1.06; 95% CI=1.01-1.12; p=0.025) were significantly associated with a greater risk of OM. Our findings suggest that children who are neutropenic, those with serum creatinine elevation, and those with a low body weight prior to chemotherapy are at greater risk of developing OM.