Salivary parameters and their correlation with absolute neutrophil counts in children undergoing chemotherapy for Acute lymphoblastic leukemia: A Prospective Cohort Study

Background: Chemotherapy is the mainstay of treatment for Acute Lymphoblastic Leukemia (ALL) and is a phased treatment modality to counter malignant cells. Although chemotherapy significantly improves the disease prognosis, its adverse effects are also manifold, including oral consequences, owing to cytotoxic damage. Methods: The present study was conducted to evaluate alterations in salivary flow rate, pH and buffering capacity at baseline, post Induction and post Consolidation phases and to correlate these parameters with Absolute Neutrophil Counts in a cohort of 43 patients, aged 3-12 years. Results: A decrease in the salivary parameters was observed at the end of Induction phase, with a statistically significant decrease in unstimulated salivary flow rates (p<0.01). Some improvement was found at the end of Consolidation phase; however, all the parameters did not reach their baselines values. 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). Conclusion: The positive correlations of salivary parameters with ANC of the subjects may be considered indicative of a concomitant immunological compromise in children with a reduction in salivary parameters.