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           for HSV-1, CMV and EBV, no samples were positive for HSV-1   Conflict of interest
           and CMV and three presented DNA amplification for EBV.
           These results highlight the literature statements that EBV oc-  The authors have no conflicts of interest to declare.
                                           27
           curs later in life in developed countries,  but mainly during
           childhood in developing countries. 28               references
              For more precise results, real-time PCR, as well as more ad-
           vanced technologies, could aid in detecting those viruses more   1. Stanulla M, Schrappe M. Treatment of Childhood Acute
                                                                 Lymphoblastic Leukemia. Semin Hematol. 2009;46:52-63.
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           detectable.  Despite the limitation of access to molecular biol-  Institute ALL Consortium protocols for children with newly
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           be concluded that the buccal alterations and the presence of   5. Sociedade Brasileira de Oncologia Pediátrica. Protocolo
           HSV-1, CMV and EBV in the evaluated ALL patients were inex-  Brasileiro de tratamento da leucemia linfóide aguda na
           pressive, with most of the patients presenting sound mucosa   infância GBTLI LLA-2009. São Paulo: Campinas; 2011;1-347.
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           It cannot be confirmed that the analyzed viruses integrate the   7. Toquica CPV, Silva PAM, Acero H. Caracterización clínico-
           microbiome of those patients. However, there are indications   epidemiológica de los pacientes pediátricos con leucemias
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           Acknowledgements                                     9. Aggarwal A, Pai KM. Orofacial Manifestations of Leukemic
                                                                 Children on Treatment: A Descriptive Study. Int J Clin Pediatr
           This study received financial support from the National   Dent 2018;11:193-8.
           Council for Scientific and Technological Development (CNPq/  10. Mendonça RM, de Araújo M, Levy CE, Morari J, Silva RA, Yunes
           Grant:486348/2013-0). The authors thank the Coordination for   JA et al. Prospective evaluation of HSV, Candida spp., and
           the Improvement of Higher Education Personnel (CAPES), the   bucal bacteria on the severity of oral mucositis in pediatric
                                                                 acute lymphoblastic leukemia. Support Care Cancer.
           Ministry of Education of Brazil for the financial support to the   2012;20:1101-7.
           Postgraduate Program in Dentistry at the Federal University   11. Chen YK, Hou HA, Chow JM, Chen YC, Hsueh PR, Tien HF. The
           of Amazonas, the Molecular Diagnostic Laboratory and Mo-  impact of oral herpes simplex virus infection and candidiasis
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           HEMOAM (Celia Maria Bolognese Ferreira and Cristina Motta   with hematological malignancies. Eur J Clin Microbiol Infect
           Ferreira), and the Foundation of Tropical Medicine (Dr. Luiz   Dis. 2011;30:753-9.
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                                                                 Wieland U et al. Association of HSV reactivation and
           Cunha for the technical collaboration.                pro-inflammatory cytokine levels with the severity of
                                                                 stomatitis after BEAM chemotherapy and autologous SCT.
                                                                 Support Care Cancer. 2011;19:1211-6.
           Ethical disclosures                                 13. Halenius A, Hengel H. Human cytomegalovirus and
           Protection of human and animal subjects. The  authors   autoimmune disease. Biomed Res Int. 2014;1-15.
           declare that the procedures followed were in accordance with   14. Chen CY, Huang KY, Shen JH, Tsao KC, Huang YC. A large-
                                                                 scale seroprevalence of epstein-barr virus in Taiwan. Plos
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                                                                 disease at day 8 of induction therapy in high-riskpediatric
           Confidentiality of data. The authors declare that they have
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           followed the protocols of their work center on the publication   6:31179.
           of patient data.                                    16. World Health Organization, 1979. Handbook for Reporting
                                                                 Results of Cancer Treatment. World Health Organization,
           Right to privacy and informed consent. The authors have   Switzerland: Geneva, 1979. E-book available on <https://apps.
           obtained the written informed consent of the patients or sub-  who.int/iris/handle/10665/37200> Access in June/2019.
           jects mentioned in the article. The corresponding author is in   17. Otmani N, Alami R, Hessissen L, Mokhtari A, Soulaymani A,
           possession of this document.                          Khattab M. Determinants of severe oral mucositis in
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