Risk factors and implications of oral mucositis in recipients of allogeneic hematopoietic stem cell transplantation

European Journal of Haematology - Tập 103 Số 4 - Trang 402-409 - 2019
Roni Shouval1,2, Elizaveta Kouniavski2, Joshua Fein2, Ivetta Danylesko2, Noga Shem‐Tov2, Mika Geva2, Ronit Yerushalmi2, Avichai Shimoni2, Arnon Nagler2
1Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Ramat-Gan, Israel
2Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel Aviv University, Ramat-Gan, Israel

Tóm tắt

AbstractBackgroundOral mucositis (OM) is a common toxicity of stem cell transplantation (SCT). We sought to evaluate OM burden, risk factors, and implications in a cohort of allogeneic‐SCT recipients.MethodsThis was a single‐center study including 115 adult allogeneic‐SCT transplanted between 2016 and 2018 for various hematological conditions. Conditioning intensity was categorized as myeloablative (MAC, 39%), reduced intensity (34%), or reduced toxicity (RTC, 27%) in patients conditioned with fludarabine‐treosulfan. OM was prospectively graded using the Common Terminology Criteria for Adverse Events (v.4.0) system.ResultsModerate‐to‐severe OM (grade 2‐4) was experienced by 60% of patients. In a univariate analysis, younger age (P = .023), lower body mass index (P = .01), recent smoking (P = .08), recent antibiotics exposure (P = .018), MAC (P < .001), and methotrexate (P = .009) were associated with moderate‐to‐severe OM. In a multivariable logistic regression model, conditioning and graft‐versus‐host disease prophylaxis remained significant. OM risk was lowest with RTC (RTC vs MAC: odd ratio [OR] 0.05, P < .001), and recent antibiotic exposure trended toward increased risk (OR 1.88, P = .168). OM was associated with longer hospitalization, delayed neutrophil engraftment, and gastrointestinal‐related infections.ConclusionOral mucositis remains a leading SCT complication. Treosulfan‐based conditioning has low mucosal toxicity and is appealing given previous reports on its high efficacy.

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European Journal of Haematology

Tập 103 Số 4

402-409

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