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Supportive Care in Cancer

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01-08-2014 | Original Article

Reduced intensity conditioning and oral care measures prevent oral mucositis and reduces days of hospitalization in allogeneic stem cell transplantation recipients

Authors: Karin Garming Legert, Mats Remberger, Olle Ringdén, Anders Heimdahl, Göran Dahllöf

Published in: Supportive Care in Cancer | Issue 8/2014

Abstract

Purpose

Oral mucositis (OM) is a side effect of intensive chemotherapy and radiation and has been reported to affect 75–100 % of hematopoietic stem cell transplantation (HSCT) recipients. The purpose of this study was to compare the incidence of OM in patients conditioned with myeloablative conditioning (MAC) to reduced-intensity conditioning (RIC) and to determine the effect of a new oral care protocol.

Methods

The study involved 171 HSCT recipients, with hematological malignancies transplanted between 2007 and 2011. Median age of the patients was 50 years (range 12–71). Ninety-nine (58 %) received RIC and 72 received MAC. Clinical features of OM were recorded from day −3 before to day +25 after HSCT using the World Health Organization (WHO) scoring system and the oral mucositis assessment score (OMAS).

Results

Overall, 87 % of the patients developed OM of any severity, which peaked on days 10–11. The mean WHO score was 1.7. In multivariate analysis, the severity of OM was associated with MAC (relative hazard (RH) 1.57, 95 % confidence interval (CI) 1.37–1.80, p < 0.001), all donor-recipient gender combinations except female-to-male (RH = 1.26, 95 % CI 1.10–1.4, p = 0.001), and early year of HSCT (RH = 0.84, 95%CI 0.7–0.96, p = 0.013). There was a correlation between long hospitalization and OM (day 15, r = 0.31, p < 0.001). There was a good correlation between the WHO and OMAS scoring systems for OM (r = 0.74, p < 0.001).

Conclusions

Oral mucositis was reduced in patients treated with RIC and in patients treated during recent years, when oral care was intensified. Increased scores of OM prolonged hospitalization.

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Title: Reduced intensity conditioning and oral care measures prevent oral mucositis and reduces days of hospitalization in allogeneic stem cell transplantation recipients
Authors: Karin Garming Legert
Mats Remberger
Olle Ringdén
Anders Heimdahl
Göran Dahllöf
Publication date: 01-08-2014
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 8/2014
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-014-2190-7

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Abstract

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