Self-reported experience of mucositis in cancer patients who underwent conditioning regimen and stem cell transplantation

Support Care Cancer. 2009 Oct;17(10):1295-9. doi: 10.1007/s00520-009-0586-6. Epub 2009 Feb 6.

Abstract

Purpose: This study was done to evaluate the frequency and severity of mucositis in the early period of stem cell transplantation (SCT) and the relation of conditioning regimens with mucositis.

Patients and methods: Patients with hematologic or solid tumors who underwent conditioning regimen were asked to score mucositis severity daily from the first day to the tenth day of reinfusion. Patient-reported scoring was performed according to a five-grade scale (0: no symptom; 1: mild; 2: moderate; 3: severe; 4: very severe). Total mucositis score (TMS) was defined as the addition of daily mucositis scores for 10 days. A total of 68 SCT (58 autologous and 10 allogeneic) patients, 48 men (71%) and 20 women (29%) were included to the study. Median age of patients was 32.5 (range 15-78) years. The most frequent three diagnosis were non-Hodgkin's lymphoma (37%, n = 25), Hodgkin's lymphoma (12%, n = 8), and multiple myeloma (12%, n = 8). BEAM (n = 27), ICE (n = 17), melphelan 200 mg/m(2) (M200)(n = 8), and TBI+C (total body irradiation + cyclophosphamide) (n = 16) were used as conditioning regimens.

Results: All of the patients experienced mucositis at any grade. TMS in the sixth day was higher than TMS in the first day (p < 0.05). TMS was not related to the diagnosis or gender (p > 0.05). TMS at ICE regimen in the first 5 days after transplantation was more severe than BEAM regimen. TMS at TBI+C regimen was higher than TMS at BEAM regimen from day 4 to day 10 (p < 0.05). The mean percentages of patients who scored severe or very severe mucositis in 10 days was 7.4% in BEAM, 8.9% in ICE, 12.5% in M200, and 31.2% in TBI+C groups.

Conclusion: Patients experience mucositis frequently following conditioning regimen and SCT. The necessity and the timing of prophylaxis for mucositis change due to the type of conditioning regimens.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Carboplatin / administration & dosage
  • Carmustine / administration & dosage
  • Cyclophosphamide / administration & dosage
  • Cytarabine / administration & dosage
  • Etoposide / administration & dosage
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hodgkin Disease / therapy
  • Humans
  • Ifosfamide / administration & dosage
  • Lymphoma, Non-Hodgkin / therapy
  • Male
  • Melphalan / administration & dosage
  • Middle Aged
  • Mucositis / chemically induced*
  • Multiple Myeloma / therapy
  • Neoplasms / therapy*
  • Severity of Illness Index
  • Whole-Body Irradiation
  • Young Adult

Substances

  • Cytarabine
  • Etoposide
  • Cyclophosphamide
  • Carboplatin
  • Melphalan
  • Carmustine
  • Ifosfamide

Supplementary concepts

  • BEAM regimen
  • ICE protocol 3