Impact of severe oral mucositis in pediatric cancer patients on resource utilization and cancer treatment plans

2021 ◽  
Author(s):  
Farah Alsheyyab ◽  
Deema Al-Momani ◽  
Rawan Kasht ◽  
Aya Kamal ◽  
Dana Abusalem ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Resource Utilization ◽  
Oral Mucositis ◽  
Pediatric Cancer ◽  
Pediatric Cancer Patients ◽  
Treatment Plans ◽  
Severe Oral Mucositis

scholarly journals Occurrence and Severity of Oral Mucositis in Brazilian Pediatric Cancer Patients

2020 ◽  
Vol 20 ◽  
Author(s):  
Hévila de Figueiredo Pires ◽  
Paula Maria Maracajá Bezerra ◽  
Victor Borges da Silva ◽  
Isabella Lima Arrais Ribeiro ◽  
Eliane Batista Medeiros Serpa ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Oral Mucositis ◽  
Pediatric Cancer ◽  
Pediatric Cancer Patients

Assessment of Oral Complications in Children Receiving Chemotherapy

2007 ◽  
Vol 31 (4) ◽  
pp. 267-273 ◽  
Author(s):  
Azza El –Housseiny ◽  
Susan Saleh ◽  
Ashraf El –Masry ◽  
Amany Allam
Keyword(s):  
Cancer Patients ◽  
Oral Mucositis ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Standard Dose ◽  
Dry Mouth ◽  
Oral Infections ◽  
Oral Complications ◽  
Oral Pain ◽  
Pediatric Cancer Patients

The aim of this study was to assess the early oral complications in pediatric patients receiving chemotherapy. An interview and oral examination was conducted on 150 pediatric cancer patients receiving standard dose chemotherapy. Results showed that oral pain and dry mouth were the most frequent patients' complaints. The prevalences of chemotherapy-induced oral mucositis and oral infections were relatively high. The chemotherapeutic antimetabolites were the most frequently associated with oral complications than other types of chemotherapy. The present results indicate that the oral complications among patients receiving chemotherapy are common

scholarly journals Mutational Consequences of Chemotherapy in Hematopoietic Stem and Progenitor Cells of Pediatric Cancer Patients

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2154-2154
Author(s):  
Eline J.M. Bertrums ◽  
Axel Rosendahl-Huber ◽  
Jurrian de Kanter ◽  
Anais C.N. van Leeuwen ◽  
Flavia Peci ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Childhood Cancer ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Post Treatment ◽  
Chemotherapeutic Drugs ◽  
Induced Mutations ◽  
Hematopoietic Stem ◽  
Pediatric Cancer Patients

Abstract Background Childhood cancer survivors are confronted with a variety of chronic health conditions as a consequence of their life saving therapy. Chemotherapy is the cornerstone of childhood cancer treatment, which consists of combinations of various drugs administered over multiple years. Most chemotherapeutic drugs act by fatally damaging the DNA or blocking the replication thereof. Although high-intensity chemotherapy efficiently eradicates tumor cells, the impact on the genomes of normal, that is noncancerous, cells remains unknown. Mutagenicity of cancer treatment on normal hematopoietic cells may contribute to the development of chronic health conditions later in life, such as therapy-related acute myeloid leukemia (t-AML). Here, we characterized the mutational consequences of chemotherapy in the genomes of hematopoietic stem and progenitor cells (HSPCs) of children treated for cancer. Methods This study was approved by the Biobank and Data Access Committee of the Princess Máxima Center for Pediatric Oncology and all samples were obtained via the in-house biobank. We performed whole-genome sequencing (WGS) on multiple single HSPCs from all patients as well as the t-AML if available. In case of t-AML patients, samples were taken before t-AML treatment. Data on mutation accumulation in HSPCs of healthy individuals from 0-63 years of age was previously acquired. To distinguish the effects of different chemotherapies, we developed an in vitro approach using cord blood HSPCs to experimentally define the mutational consequences of individual chemotherapeutic drugs in primary human cells. Results Our cohort consisted of 22 pediatric cancer patients of which we obtained bone marrow aspirates and/or peripheral blood from timepoints pre- and post-treatment for their first cancer. We included 17 t-AML patients with varying first cancer diagnoses and five acute lymphoblastic leukemia (ALL) patients who did not develop t-AML. Patient characteristics and therapy information is described in Table 1. We compared the mutational burden of pre- and post-treatment HSPCs of the childhood cancer patients to those of healthy treatment-naïve individuals. HSPCs at time of first diagnosis of childhood cancer patients displayed a mutation burden similar to HSPCs of healthy individuals. In contrast, post-treatment HSPCs showed a significantly higher increase in mutation number over time than expected by normal ageing. We used mutational signature analysis to pinpoint the causes of this increased mutation burden in post-treatment HSPCs. Surprisingly, in most of these HSPCs the additive mutational effect could be attributed to clock-like processes, active during normal aging. Only few chemotherapeutic drugs showed direct mutagenic effects, such as platinum drugs and thiopurines. Whereas cisplatin-induced mutations could be observed in all cells exposed to this drug, thiopurine-induced mutations were present in a subset of the exposed HSPCs. These differences in thiopurine-induced mutagenesis across multiple exposed HSPCs could even be observed within individual patients. In one patient, the HSPCs containing the thiopurine-signature shared the oncogenic MLL-rearrangement with the t-AML blasts and had shorter telomeres compared to the HSPCs without this signature. This finding indicates that these cells have undergone more cell divisions, suggesting that thiopurine-induced mutagenesis requires DNA replication. We also identified novel therapy-associated mutational signatures. One of these signatures was observed in multiple patients who received a hematopoietic stem cell transplantation, as part of their cancer treatment, after which they displayed a viral reactivation for which they were treated. By WGS of in vitro exposed cord blood HSPCs, we demonstrated that this signature is caused by the antiviral drug ganciclovir, which is commonly used to treat cytomegalovirus infections. The second signature was present in HSPCs of a patient who received a combination of thiotepa and treosulfan. Conclusions Enhanced mutation accumulation after pediatric cancer treatment is caused by both direct and indirect mechanisms. The variance in mutagenic effects of (chemo)therapies on healthy HSPCs may influence the risk an individual patient has to develop t-AML and could, in future, play a role in t-AML risk assessment of pediatric cancer survivors and the development of new treatment regimens. Figure 1 Figure 1. Disclosures Zwaan: Sanofi: Consultancy.

scholarly journals The Contribution of Motor Changes to Oral Mucositis in Pediatric Cancer Patients: A Cross-Sectional Study

2019 ◽  
Vol 16 (18) ◽  
pp. 3395
Author(s):  
Nyellisonn N. N. Lucena ◽  
Lecidamia C. L. Damascena ◽  
Isabella L. A. Ribeiro ◽  
Luiz M. A. Lima-Filho ◽  
Ana Maria G. Valença
Keyword(s):  
Children And Adolescents ◽  
Cancer Patients ◽  
Oral Mucositis ◽  
Pediatric Cancer ◽  
Body Position ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pediatric Cancer Patients ◽  
Antineoplastic Treatment

This study aimed to investigate the contribution of motor changes to oral mucositis in children and adolescents with cancer undergoing antineoplastic treatment in a referral hospital. This was an observational, cross-sectional study with 70 patients aged 2 to 19 years, diagnosed with any type of cancer and treated in a pediatric hospital cancer ward from April to September 2017. A questionnaire related to the patients’ socioeconomic and clinical conditions was used, followed by the Oral Assessment Guide and selected domains of the activity and participation section of the International Classification of Functioning, Disability, and Health tool. The data were collected by previously calibrated examiners (kappa index > 0.75) and analyzed using descriptive statistics and logistic regression (α = 5%). Children and adolescents aged 7 to 10 years were more likely to develop oral mucositis (OR: 3.62). In addition, individuals who had severe difficulty in maintaining a body position (OR: 14.45) and walking (OR: 25.42), and those diagnosed with hematologic cancers (OR: 6.40) were more likely to develop oral mucositis during antineoplastic treatment. Within the limitations of this study, it is concluded that motor changes may contribute to the occurrence of oral mucositis in pediatric cancer patients.

scholarly journals Effects of Honey on Oral Mucositis among Pediatric Cancer Patients Undergoing Chemo/Radiotherapy Treatment at King Abdulaziz University Hospital in Jeddah, Kingdom of Saudi Arabia

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Soad K. Al Jaouni ◽  
Mohammad S. Al Muhayawi ◽  
Abear Hussein ◽  
Iman Elfiki ◽  
Rajaa Al-Raddadi ◽  
...  
Keyword(s):  
Body Weight ◽  
Treatment Group ◽  
Cancer Patients ◽  
Oral Mucositis ◽  
Pediatric Cancer ◽  
Fungal Infections ◽  
Controlled Study ◽  
Integrative Approach ◽  
Therapeutic Effects ◽  
Pediatric Cancer Patients

One of the most common complications of cancer chemotherapy is oral mucositis. This study evaluates the therapeutic effects of honey with the focus on grade III and IV oral mucositis, reduction of bacterial and fungal infections, duration of episodes of oral mucositis, and body weight in pediatric leukemic patients undergoing chemo/radiotherapy. This is an open labeled randomized controlled study conducted at our hospital on 40 pediatric cancer patients undergoing chemo/radiotherapy. All the 40 patients included in this study experienced a sum total of 390 episodes of fever and neutropenia associated with oral mucositis. A significant reduction of oral mucositis, associatedCandida, and aerobic pathogenic bacterial infections was noted in patients in the honey treatment group. Also, there is a significant decrease in the duration of hospitalization for all those in the treatment group combined with a significant increase of body weight, delayed onset, and decreased severity of pain related to oral mucositis. Complications of oral mucositis can be tremendously reduced by the topical application of local Saudi honey and honey should be used as an integrative approach in prophylaxis and treatment of chemo/radiotherapy-induced oral mucositis in pediatric cancer patients. Further research is needed to elucidate and better understand the underlying mechanism.

scholarly journals Adverse Events During Supervised Exercise Interventions in Pediatric Oncology—A Nationwide Survey

2021 ◽  
Vol 9 ◽  
Author(s):  
Gabriele Gauß ◽  
Ronja Beller ◽  
Joachim Boos ◽  
Julia Däggelmann ◽  
Hannah Stalf ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Exercise Intervention ◽  
Exercise Programs ◽  
Exercise Interventions ◽  
Supervised Exercise ◽  
Pediatric Cancer Patients ◽  
Safety Procedures

Objectives: Exercise interventions during and after treatment for pediatric cancer are associated with beneficial physical, psychological, and social effects. However, valid data about adverse events (AEs) of such interventions have rarely been evaluated. This retrospective study evaluates AEs that occurred during supervised oncological exercise programs for pediatric cancer patients and survivors.Methods: This Germany-wide study used a self-administered online survey focusing on general program characteristics and AEs retrospectively for 2019. The questionnaire included (a) basic data on the offered exercise program, (b) AEs with consequences (Grade 2–5) that occurred in 2019 during an exercise intervention, (c) number of Grade 1 AEs, (d) safety procedures as part of the exercise programs, and (e) possibility to give feedback and describe experience with AEs in free text.Results: Out of 26 eligible exercise programs, response rate of program leaders was 92.3% (n = 24). Representatives working for Universities (n = 6), rehabilitation clinics (n = 3), acute cancer clinics (n = 12), and activity camps (n = 3) participated. In total, 35,110 exercise interventions with varying duration were recorded for 2019. Six AEs with consequences (Grade 2–3) occurred during exercise interventions after cancer treatment resulting in an incidence of 17 per 100,000 exercise interventions (0.017%). No life-threatening consequences or death were reported and no serious AE occurred during acute cancer treatment. Grade 1 AE occurred with a frequency of 983, corresponding to an incidence of 2,800 per 100,000 interventions (2.8%). Most frequent Grade 1 AE were muscle soreness, circulatory problems, and abdominal pain. The most frequent preventive safety procedures at the institutions were regular breaks, consultations with the medical treatment team, and material selection with low injury potential.Conclusions: Supervised exercise interventions for pediatric cancer patients and survivors seem to be safe and AEs with consequences comparatively rare when compared to general childhood population data. Occurrence of grade 1 AEs was common, however, causality was probably not evident between AEs and the exercise intervention. Future research should standardize assessment of AEs in clinical practice and research, and prospectively register and evaluate AEs that occur in the context of exercise interventions in pediatric cancer patients and survivors.

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