Effects of cryotherapy on high‐dose melphalan‐induced oral mucositis in pediatric patients undergoing autologous stem cell transplantation

Abstract

Cryotherapy is a conventional method for preventing melphalan‐induced oral mucositis (OM) in adult patients. We retrospectively examined the clinical benefits of cryotherapy in 41 pediatric patients undergoing autologous stem cell transplantation using a melphalan‐etoposide‐carboplatin regimen. Twenty‐two patients received cryotherapy. The cumulative incidence of grade 3‐4 OM was significantly lower in the cryotherapy group (57.1%) than in the noncryotherapy group (89.5%; P = .041). Multivariate analyses identified cryotherapy and the melphalan dose as independent factors for the lower occurrence of OM. The present study demonstrates the clinically significant efficacy of cryotherapy for preventing melphalan‐induced OM in pediatric patients.

Clinical practice guideline for the prevention of oral and oropharyngeal mucositis in pediatric cancer and hematopoietic stem cell transplant patients: 2021 update

“…No adverse effects were reported in these two RCTs or the other pediatric studies (Appendix 8). In terms of feasibility, two studies suggested compliance was worse in younger patients, specifically in those younger than 7 years [24,26].…”

Cryotherapy for oral mucositis in cancer: review of systematic reviews and meta-analysis

“…Ultimately, 10 SRMAs were found to match the criteria and were included 14 33–41. Among the meta-analyses, 25 RCTs17–19 42–62 were included in the umbrella review. From the included meta-analyses, we excluded primary RCTs without control groups,16 63–66 and those with multicomponent interventions,65 non-randomised designs67 and those without full text 68 Online supplemental table 3.…”

“…Studies were published between 1991 and 2019. All studies included both sexes, with two conducted on children53 54 and the rest on adults 17–19 42–52 55–62 66. Included trials were from Sweden,50 53 57 60 Turkey,17 18 44 Italy,19 42 47 USA,45 46 62 Iran,43 58 59 China,61 66 Brazil,51 56 Malaysia,52 Greece,55 Canada,48 Japan54 and Denmark 49.…”

“…All studies included both sexes, with two conducted on children53 54 and the rest on adults 17–19 42–52 55–62 66. Included trials were from Sweden,50 53 57 60 Turkey,17 18 44 Italy,19 42 47 USA,45 46 62 Iran,43 58 59 China,61 66 Brazil,51 56 Malaysia,52 Greece,55 Canada,48 Japan54 and Denmark 49. Thirteen studies compared OC with basic oral care,17–19 44 48 50 52–55 58–60 two with normal saline (NS),43 62 two with chlorohexidine (CHX)49 66 and one with NS/CHX,50 laser therapy,56 leucovorin61 and plain cryotherapy 51.…”

“…Included trials were from Sweden,50 53 57 60 Turkey,17 18 44 Italy,19 42 47 USA,45 46 62 Iran,43 58 59 China,61 66 Brazil,51 56 Malaysia,52 Greece,55 Canada,48 Japan54 and Denmark 49. Thirteen studies compared OC with basic oral care,17–19 44 48 50 52–55 58–60 two with normal saline (NS),43 62 two with chlorohexidine (CHX)49 66 and one with NS/CHX,50 laser therapy,56 leucovorin61 and plain cryotherapy 51. Thirteen of the studies included samples diagnosed with haematological cancers19 43 45 47 48 50 53 56 57 59 60 62 66 and 12 included those with solid cancers 17 18 42 44 46 49 51 52 54 55 58 61.…”