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Doctoral Thesis
DOI
https://doi.org/10.11606/T.25.2022.tde-11112022-172203
Document
Author
Full name
Reyna Aguilar Quispe
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2022
Supervisor
Committee
Santos, Paulo Sergio da Silva (President)
Bastos, Roosevelt da Silva
Coracin, Fábio Luiz
Grando, Liliane Janete
Title in Portuguese
Estudo da condição bucal e qualidade de vida de indivíduos infantojuvenis com leucemia antes e durante o tratamento antineoplásico
Keywords in Portuguese
Criança
Leucemia
Qualidade de Vida
Saúde bucal
Abstract in Portuguese
A leucemia é uma das doenças malignas mais prevalentes na população infantojuvenil e de manifestação sistêmica incluindo a boca. O objetivo da presente pesquisa foi comparar a condição da saúde bucal e seu impacto na qualidade de vida de indivíduos infantojuvenis com leucemia antes e durante o tratamento antineoplásico (TA). Esta pesquisa foi longitudinal prospectiva com amostra por conveniência. Os critérios de inclusão foram: indivíduos com diagnóstico definitivo de leucemia linfoide aguda (LLA) e leucemia mieloide aguda (LMA), com idade de 3 a 17 anos, sem distinção de etnia ou sexo. Com protocolo de quimioterapia Berlim-Frankfurt-Münster (BFM), e sem associação a síndromes relacionados à leucemia. Foram excluídos indivíduos que recusaram a participar da pesquisa, com antecedentes de outras neoplasias, maiores de 17 anos e sem protocolo de quimioterapia BFM. Foram coletados dados como idade, sexo, etnia, diagnóstico. Valores de exames de hemácias, hemoglobina, hematócrito, leucócitos, neutrófilos e plaquetas. Para avaliação da condição da saúde bucal, foram utilizados os índices CPO-D/ceo-d, índice gengival, IHO-S, graduação da mucosite oral (MO) da OMS, assim como registro da localização da MO. Os tempos de avaliação foram entre 6 a 8 momentos diferentes do TA. O impacto da saúde bucal na qualidade de vida foi avaliado através do questionário OHIP-14. Para comparação de 2 amostras pareadas foi utilizado o test-t pareado e para comparação de mais de 2 amostras pareadas o teste Anova de medidas repetidas. Foram realizadas um total de 77 avaliações da condição bucal. Houve petéquias e gengivorragia em 40% dos indivíduos infantojuvenis com leucemia antes do TA. A MO esteve presente em 48,28%, com maior manifestação e gravidade na fase de consolidação (p<0,05). A higiene bucal e saúde gengival pioraram durante a fase de consolidação, porém sem diferença antes do TA (p>0,05). Houve um aumento da prevalência de carie dentaria quando comparado antes do TA (p<0,05). A saúde bucal teve um impacto negativo na qualidade de vida durante o TA (p<0,05), afetando principalmente as dimensões de dor física, limitação funcional, desconforto psicológico e incapacidade física consecutivamente. A saúde bucal dos indivíduos infantojuvenis com leucemia piorou durante o TA, principalmente na fase de consolidação com um impacto negativo na qualidade de vida.
Title in English
Study of oral health and quality of life in children with leukemia before and during antineoplastic therapy
Keywords in English
Child
Leukemia
Oral health
Quality of life
Abstract in English
Leukemia is one of the most prevalent malignant diseases in the infant-juvenile population with systemic manifestation including the mouth. The aim of this study was to compare the oral health and its impact on the quality of life of children with leukemia before and during antineoplastic treatment (AT). This research was a prospective longitudinal study with convenience sample. Inclusion criteria were individuals with a definitive diagnosis of acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML), aged 3 to 17 years, without distinction of ethnicity or gender. With Berlin-Frankfurt-Münster (BFM) chemotherapy protocol, and no association with leukemia-related syndromes. Individuals who refused to participate in the study, with a history of other neoplasms, older than 17 years and without chemotherapy protocol BFM were excluded. Data such as age, gender, ethnicity, diagnosis were collected. Values of red blood cells, hemoglobin, hematocrit, leukocytes, neutrophils, and platelets also were collected. To assess the oral health, the DMFT/dmft index, gingival index, IHO-S, OMS oral mucositis (OM) indexes, as well as the recording of the location of OM, were used. The evaluation times were between 6 and 8 at different moments of AT. The impact of oral health on quality of life was assessed using the OHIP-14 questionnaire. For comparison of 2 paired samples, the paired test-t was used and the Anova test of repeated measures was used to compare more than 2 paired samples. A total of 77 oral health evaluations were performed. There were petechiae and gingival bleeding in 40% of leukemic children before AT. OM was present in 48.28%, with greater manifestation and severity in the consolidation phase (p<0.05). Oral hygiene and gingival health worsened during the consolidation phase, but with no difference before AT (p>0.05). There was an increase in the prevalence of dental caries when compared before AT (p<0.05). Oral health had a negative impact on quality of life during AT (p<0.05), mainly affecting the dimensions of physical pain, functional limitation, psychological discomfort, and physical disability consecutively. The oral health of children with leukemia worsened during AT, especially in the consolidation phase with a negative impact on quality of life.
 
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Release Date
2024-07-22
Publishing Date
2022-11-21
 
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