Stem cell transplantation patients receiving a novel oral care protocol for oral mucositis prevention and treatment: patient-reported outcomes and quality of life

Abstract

Background Oral mucositis (OM) is one of the most debilitating effects of toxicity due to hematopoietic stem cell transplantation (HSCT) conditioning regimens. The aim of this secondary analysis of the data of a phase II study designed to assess the efficacy of a novel oral care protocol containing bovine colostrum and aloe vera to prevent oral mucositis was to compare outcomes reported by patients with those collected by healthcare professionals (HCPs). Method Data on oral mucositis severity, duration, time of onset and related pain were collected from patients using the Oral Mucositis Daily Questionnaire (OMDQ). HCPs assessed the same outcomes using the World Health Organization oral mucositis scale and pain numerical rating scale. Quality of life was assessed with the 3-level EuroQol-5 dimensions. Results Fifty-nine autologous/allogeneic graft patients were recruited, 46 of whom (78.0%) experienced OM. Mean onset was 9.1 (SD ± 3.5) days after conditioning initiation, mean duration was 10.4 (SD ± 4.3) days, and the average maximum pain score was 3.7 (SD ± 2.7). Self-administration of the OMDQ detected oral symptoms at least 1 day sooner compared to objective assessments (p = 0.025). Significant differences were observed between the patient-reported and the HCP-assessment data on oral mucositis severity grading distribution (p < 0.0001) and highest pain score (p < 0.0001). Quality of life score variations were correlated with changes in oral mucositis severity during patients’ hospital stay. Conclusions Further studies are necessary to improve the understanding of these findings; a randomised controlled trial is being set up at our institution.

The effect of self-care education with smart phone applications on the severity of mucositis and infection after stem cell transplantation in leukemia patients

“…Concordant with this nding, Vale et al observed that 60.7% of patients developed mucositis after SCT, and a preventive regimen could effectively reduce the process of mucositis in these patients (28). Guberti et al also claimed that 78% of SCT patients experienced mucositis, and using the applied protocol reduced the severity of their mucositis and improved their quality of life, which is in agreement with our ndings (29). In a similar study but with a different intervention, Hadid et al found very high mucositis levels in chemotherapy patients in grades 3 and 4, and palifermin could reduce mucositis severity in patients undergoing chemotherapy (30).…”

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

“…Pathobiologically, onset of the first phase of OM occurs immediately after starting chemotherapy, and the healing phase usually occurs approximately 2 to 4 weeks after the final day of chemotherapy [18][19][20]. Clinically, the mean onset of OM was 9.1 days after initiation of the conditioning regimen and that the duration was 10.4 days in patients undergoing HSCT [17]. Onset and healing of OM in this study indicated in accordance with these reports.…”

“…Vagliano et al [16] reported that 71.4% of patients undergoing HSCT developed OM and that 21.6% had ≥ G3 OM. Guberti et al [17] found that 78.0% of patients who underwent HSCT developed OM. In a systematic review, the incidence of OM in patients undergoing HSCT was 83.5% among seven studies [2].…”

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

“…Vagliano et al [16] reported that 71.4% of patients undergoing HSCT developed OM and that 21.6% had ≥ G3 OM. Guberti et al [17] found that 78.0% of patients who underwent HSCT developed OM. In a systematic review, the incidence of OM in patients undergoing HSCT was 83.5% among seven studies [18].…”

“…Pathological onset of the rst phase of OM occurs immediately after starting chemotherapy, and the healing phase usually occurs approximately 2 to 4 weeks after the nal day of chemotherapy [19][20][21]. Guberti et al [17] reported that the mean onset of OM was 9.1 days after initiation of the conditioning regimen and that the duration was 10.4 days in patients undergoing HSCT. Our results are similar to these reports and are considered valid because the cells of the oral cavity usually have a turnover cycle of 7 to 14 days [22].…”