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Prevention of cytarabine-induced kerato-conjunctivitis by eye rinse in patients receiving high-dose cytarabine and total body irradiation as a conditioning for hematopoietic stem cell transplantation

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Abstract

We previously reported a high incidence of kerato-conjunctivitis in patients receiving high-dose cytarabine following total body irradiation (TBI) as a conditioning for hematopoietic stem cell transplantation (HSCT) even on prophylaxis with topical corticosteroid. This study aimed to evaluate whether addition of eye rinse, which was designed to remove cytarabine from ocular surface, further reduces the incidence of kerato-conjunctivitis in the same setting. Seventy-six patients receiving cytarabine at a dose of 3 g/m2 every 12 h for 4 days after receiving TBI (12 Gy) as conditioning for HSCT were evaluated. All patients received betamethasone sodium phosphate eye drops. Twenty-three patients were further instructed to rinse their eyes with sterile saline every 10–15 min during and for two additional hours after the completion of each cytarabine infusion. Among 23 patients with eye rinse, Grades 2–3 and 1–3 kerato-conjunctivitis were observed in 4 (17.4%) and 5 patients (21.7%), respectively. These incidences were significantly lower than those [35 (66.0%) and 41 (77.4%)] observed in 53 patients without eye rinse (P < 0.001 and P < 0.00001, respectively). These results strongly suggest that eye rinse effectively reduces the incidence and severity of cytarabine-induced kerato-conjunctivitis in HSCT recipients who receive high-dose cytarabine following TBI.

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Authors and Affiliations

  1. Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, 160-8582, Tokyo, Japan

    Takehiko Mori, Jun Kato, Akiko Yamane, Yoshinobu Aisa, Takayuki Shimizu & Shinichiro Okamoto

  2. Novartis Pharma Program for Clinical Therapeutics of Hematologic Malignancy, Keio University School of Medicine, Tokyo, Japan

    Jun Kato & Akiko Yamane

  3. Department of Nursing, Keio University Hospital, Tokyo, Japan

    Yusuke Kawata, Mayu Ichimura, Chiaki Tsuneyama & Tomoko Yashima

  4. Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan

    Yoko Ogawa & Kazuo Tsubota

  5. Department of Radiology, Keio University School of Medicine, Tokyo, Japan

    Naoyuki Shigematsu

Authors
  1. Takehiko Mori
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  2. Jun Kato
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  3. Akiko Yamane
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  4. Yoshinobu Aisa
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  5. Yusuke Kawata
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  6. Mayu Ichimura
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  7. Chiaki Tsuneyama
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  8. Tomoko Yashima
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  9. Yoko Ogawa
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  10. Kazuo Tsubota
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  11. Naoyuki Shigematsu
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  12. Takayuki Shimizu
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  13. Shinichiro Okamoto
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Correspondence to Takehiko Mori.

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Mori, T., Kato, J., Yamane, A. et al. Prevention of cytarabine-induced kerato-conjunctivitis by eye rinse in patients receiving high-dose cytarabine and total body irradiation as a conditioning for hematopoietic stem cell transplantation. Int J Hematol 94, 261–265 (2011). https://doi.org/10.1007/s12185-011-0912-x

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  • DOI: https://doi.org/10.1007/s12185-011-0912-x

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