Oral mucositis in patients with acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation in relation to the conditioning used prior to transplantation

Abstract

This study was designed to investigate the frequency and severity of oral mucositis in patients with acute myeloid leukemia after allogeneic hematopoietic cell transplantation, in relation to the type of conditioning used. Eighty patients diagnosed with acute myeloid leukemia were assigned to two groups based on the conditioning regimen used before transplantation. The intensity of oral inflammatory lesions induced by chemotherapy (oral mucositis) was evaluated according to a 5-point scale recommended by World Health Organization. Oral mucosa was investigated in all patients before the transplantation and during two subsequent stages of the post-transplantation procedure in relation to the conditioning regimen used. Mucositis in the oral cavity was observed in the majority of patients (66%) in the first week after transplantation, whereas the largest percentage of patients suffering oral lesions (74%) occurred in the second week after transplantation. A significantly higher percentage of patients with mucositis was observed in the group which underwent myeloablation therapy (74% of MAC and 50% of RIC patients in the first week; 83% of MAC and 53% of RIC patients in the second examination).The severity of mucositis after transplantation was higher in the MAC patients compared to the RIC patients. The highest mean value of the mucositis index was recorded in the second week in the MAC group (1.59). In AML sufferers receiving allo-HSCT, oral mucositis is a significant complication of the transplantation. This condition is more frequent and more severe in patients after treatment with myeloablation therapy.

Hangeshashinto for prevention of oral mucositis in patients undergoing hematopoietic stem cell transplantation: a randomized phase II study

“…In the Nagasaki Transplant Group, the conditioning intensity is determined by the consensus of the Center for International Blood and Marrow Transplant Research criteria [22,23]. Several reports have shown that the appearance of OM with chemotherapy depends on the dose and type of chemotherapy and that the incidence of OM is higher with MAC than RIC regimens in patients undergoing HSCT [24,25]. These findings are in agreement with our results.…”

Hangeshashinto for prevention of oral mucositis in patients undergoing hematopoietic stem cell transplantation: a randomized phase II study

“…In the Nagasaki Transplant Group, the conditioning intensity is determined by the consensus of the Center for International Blood and Marrow Transplant Research criteria [24,25]. Several reports have shown that the appearance of OM with chemotherapy depends on the dose and type of chemotherapy and that the incidence of OM is higher with MAC than RIC regimens in patients undergoing HSCT [26,27].…”

Salivary inflammatory mediators as biomarkers for oral mucositis and oral mucosal dryness in cancer patients: A pilot study

“…Numerous studies focus on individual cancer types; thus, it is difficult to generalize OM as a common side effect of therapy in patients with cancer [ 6 , 8 , 15 , 19 ]. We recruited several patients with leukemia and head and neck carcinoma in an attempt to provide a broader representation of patients with OM.…”

“…OM occurs as a common side effect in patients with cancer receiving chemotherapy (CTx) and radiotherapy (RT), which can be severe and impede the quality of life [ 2 – 4 ]. More than 75% of the patients with leukemia undergoing CTx and bone marrow transplantation (BMT) experience OM [ 5 , 6 ], and > 40% of those receiving RT experience ≥ grade 3 OM [ 7 , 8 ].…”