Estimating The Density of Candida Albicans in Children with Acute Lymphoblastic Leukemia (A Pilot Study)

Introduction: Oral Candidosis is among the find-ings of acute leukemia. The aim of this study was to evaluate the changes in the intensity of C.albicans, before treatment and at the Induc-tion phase.  Materials and Methods: Twelve patients with Acute Lymphoblastic Leukemia (ALL) aged 2-14 years enrolled in study. Whole Saliva samples were obtained and cultured to determine the mean count of C.albicans Colony Forming Units (CFU) before induction of leukemia, and at days 35 and 64 of induction. White blood cell counts were also determined at the same time. Data were transferred to SPSS 19 and analyzed using paired and Independent t-test, Chi square, and stepwise regression.  Results: The mean CFU count was significantly increased before beginning of the treatment [22.41±10.47] to days 35[28.5±9.29] (P=0.006) and 64 of induction[30.5±11.82] (P=0.009) an-dat the first day of consolidation [49.66±3.01] (P=0.032).The quantity of colonies was sparse (10-100 CFU/ml) without clinical manifestations of oral candidiasis. Main predictors of C.albicans colonization were age and white blood cell count (WBC). Children younger than age 10 yrs (OR=-19.7, 95% CL [12.37-15.82 for day 35 eval-uation] and (OR=-0.002, 95% CL[-0.004-0.00 inday 64]and those with lower WBC (OR=-13.47, 95% CL [-25.29 -1.65]) showed higher risks of colonization.  Conclusion: C.albicans colonization was ob-served among the leukemia child patients at early phase of treatment without clinical mani-festations. The predictors of colonization were age and white blood cell counts.