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Salivary parameters and their correlation with neutrophil counts in children with acute lymphoblastic leukemia
1Pediatric Dentistry Unit, Department of Oral Health Sciences, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Chemotherapy for acute lymphoblastic leukemia (ALL) significantly reduces salivary function in children. These changes correlate with lower Absolute Neutrophil Counts (ANC), indicating immune compromise.
Area of Science:
- Pediatric Oncology
- Oral Medicine
- Immunology
Background:
- Chemotherapy for Acute Lymphoblastic Leukemia (ALL) induces immunosuppression in children.
- Reduced salivary function may exacerbate chemotherapy's adverse effects.
- This study investigates salivary changes during ALL treatment.
Purpose of the Study:
- To evaluate alterations in salivary flow rate, pH, and buffering capacity in children undergoing ALL chemotherapy.
- To correlate these salivary parameters with Absolute Neutrophil Counts (ANC).
Main Methods:
- A cohort of 43 pediatric patients (3-12 years) was studied.
- Salivary parameters and ANC were measured at baseline, post-induction, and post-consolidation chemotherapy phases.
- Data were analyzed for correlations between salivary function and ANC.
Main Results:
- A significant decrease in unstimulated salivary flow rate was observed post-induction compared to baseline (p < 0.01).
- Statistically significant positive correlations were found between ANC and salivary flow rate (p=0.005), pH (p < 0.00), and buffering capacity (p < 0.00).
Conclusions:
- Salivary parameters are significantly altered during ALL chemotherapy, with maximum derangement post-induction.
- The positive correlation between salivary parameters and ANC suggests concurrent immunological compromise in these pediatric patients.
Background:
Chemotherapy for Acute Lymphoblastic Leukemia (ALL) is known to render children immuno-deficient. A concomitant suppression of local defence mechanisms, such as saliva may further aggravate the adverse consequences of chemotherapy. The present study was conducted to evaluate alterations in salivary flow rate, pH and buffering capacity and to correlate these parameters with Absolute Neutrophil Counts (ANC).
Methods:
A cohort of 43 patients, aged 3-12 years were evaluated for the aforementioned parameters at baseline, post-induction and post-consolidation phases. Salivary collection was done and ANC was measured from routine haematological reports.
Results:
A decrease in the salivary parameters was observed at the end of Induction phase as compared to baseline, with a statistically significant decrease in unstimulated salivary flow rates (p < 0.01). Statistically significant positive correlations were found between ANC and salivary flow rate (p = 0.005), pH (p < 0.00) and buffering capacity (p < 0.00). On testing the significance of these correlations, all the values for these parameters were found to be statistically significant.
Conclusion:
Salivary parameters showed derangements over the phases of chemotherapy, with maximum decrease at the end of induction phase. The positive correlations of salivary parameters with ANC of the subjects may be considered indicative of a concomitant immunological compromise in these children.
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