Abstract Ref Number = APCP247
ZINC SUPPLEMENTATION REDUCE THE SEVERITY OF ORAL MUCOSITIS DUE TO CHEMOTHERAPY IN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA
Manik Arysanti,Ariawati Ketut,Subanada Ida Bagus
FK Udayana Departement of Child Health, Medical Faculty, Udayana University, Sanglah Hospital, Denpasar, Indonesia
Background : Oral mucositis is one of the side effects of chemotherapy in cancer treatment. The implication of oral mucositis is delaying in cancer treatment, extending the length of stay, increasing hospital costs and increasing the risk of infection. This study was conducted to investigate the effects of zinc supplementation in reducing the incidence and severity of chemotherapy-induced oral mucositis in children with acute lymphoblastic leukemia.
Material : A double-blind randomized controlled trial was carried out among 40 selected children undergoing chemotherapy of acute lymphoblastic leukemia in Sanglah Hospital. The subjects were randomly assigned to receive standard therapy of oral mucositis with zinc supplementation or with placebo during 6 weeks in consolidation phase. The severity of oral mucositis was evaluated by NCI-CTAE. The bivariate analysis of incidence and severity of oral mucositis in zinc and placebo groups were using Chi-square and Fisher Exact test. Analysis of time incidence mucositis during the period of observation were using survival analysis and presented in a Kaplan-Meier curves. Multivariate analysis of confounding variables was using Cox Regression Testing Hazard Model.
Results : The incidence of oral mucositis was 40% in the zinc group and 55% in the placebo group. There were no significant differences for the incidence of mucositis in zinc and placebo groups (p=0.342), but the difference between the severity of oral mucositis were significant (p=0.024, RR 0.306 ; 95%CI: 0.089 to 1.048). In Cox Regression analysis, it obtained the strong predictor variables for the incidence of mucositis were age, nutritional status and levels of zinc.
Conclusions : Zinc supplementation does not reduce the incidence of chemotherapy-induced oral mucositis in consolidation phase of acute lymphoblastic leukemia, but can reduce the severity of oral mucositis compared to placebo.
Keywords: Oral mucositis zinc supplementation chemotherapy leukemia lymphoblastic acute