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Oral cryotherapy for the prevention of high-dose melphalan-induced stomatitis in allogeneic hematopoietic stem cell transplant recipients

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Abstract

Goals

The purpose of this study was to evaluate the efficacy of oral cryotherapy to prevent high-dose melphalan-induced stomatitis.

Patients and methods

Eighteen consecutive recipients of allogeneic hematopoietic stem cell transplant conditioned with high-dose melphalan (140 mg/m2) in combination with fludarabine alone or with fludarabine and additional chemotherapy or radiation were enrolled. The severity of stomatitis was graded according to the National Cancer Institute Common Toxicity Criteria. Patients were kept on oral cryotherapy using ice chips and ice-cold water shortly before, during, and for additional 90 min after completion of melphalan administration.

Results

Only two of 18 patients (11.1%) developed grade 2 or 3 stomatitis while six of seven patients in the historical control developed it (85.7%; P=0.001).

Conclusion

These results suggested that oral cryotherapy could effectively prevent stomatitis caused by high-dose melphalan, and we recommend that it should be incorporated into the conditioning regimen with high-dose melphalan.

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References

  1. Cascinu S, Fedeli A, Fedeli SL, Catalano G (1994) Oral cooling (cryotherapy), an effective treatment for the prevention of 5-fluorouracil-induced stomatitis. Oral Oncol, Eur J Cancer 30B:234–236

    Google Scholar 

  2. Devine SM, Sanborn R, Jessoop E, Stock W, Huml M, Peace D, Wickrema A, Yassine M, Amin K. Thomason D, Chen Y-H, Devine H, Maningo M, van Besien K (2001) Fludarabine and melphalan-based conditioning for patients with advanced hematological malignancies relapsing after a previous hematopoietic stem cell transplant. Bone Marrow Transplant 28:557–562

    Article  Google Scholar 

  3. Dumonet C, Sonnet A, Bastion Y, Salles G, Espinouse D, Coiffier B (1994) Prevention of high dose L-PAM-induced mucositis by cryotherapy. Bone Marrow Transplant 3:492-494

    Google Scholar 

  4. Giralt S, Aleman A, Anagnostopoulos A, Weber D, Khouri I, Anderlini P, Molldrem J, Ueno NT, Donato M, Korbling M, Gajewski J, Alexanian R, Champlin R (2002) Fludarabine/melphalan conditioning for allogeneic transplantation in patients with multiple myeloma. Bone Marrow Transplant 30:367–373

    Article  Google Scholar 

  5. Gouyette A, Hartman O, Pico J-L (1986) Pharmacokinetics of high-dose melphalan in children and adults. Cancer Chemother Pharmacol 16:184–189

    Article  Google Scholar 

  6. Kroger N, Schwerdrfeger R, Kiehl M, Sayer HG, Renges H, Zabelina T, Fehse B, Togel F, Wittkowsky G, Kuse R, Zander AR (2002) Autologous stem cell transplantation followed by a dose-reduced allograft induces high complete remission rate in multiple myeloma. Blood 100:755–760

    Article  CAS  PubMed  Google Scholar 

  7. Kroger N, Sayer HG, Schwerdtfeger R, Kiehl M, Nagler A, Renges H, Zabelina T, Fehse B, Ayuk F, Wittkowsky G, Schmitz N, Zander AR (2002) Unrelated stem cell transplantation in multiple myeloma after a reduced-intensity conditioning with pretransplantation antithymocyte globulin is highly effective with low transplant-related mortality. Blood 100:3919–3924

    Article  CAS  PubMed  Google Scholar 

  8. Mahood DJ, Dose AM, Loprinzi CL, Veeder MH, Athmann LM, Therneau TM, Sorensen JM, Gainey DK, Mailliard JA, Gusa NL, Finck Gk, Johnson C, Goldberg RM (1991) Inhibition of fluorouracil-induced stomatitis by oral cryotherapy. J Clin Oncol 9:449–452

    Google Scholar 

  9. Meloni G, Capria S, Proia A, Trisolini SM, Mandelli F (1996) Ice pops to prevent melphalan-induced stomatitis. Lancet 347:1691–1692

    Article  Google Scholar 

  10. Rocke LK, Loprinzi CL, Lee JK, Kunselman SJ, Iverson RK, Finck G, Lifsey D, Glaw KC, Stevens BA, Hatfield AK, Vaught NL, Bartel J, Pierson N (1993) A randomized clinical trial of two different durations of oral cryotherapy for prevention of fluorouracil-related stomatitis. Cancer 72:2234–2238

    Google Scholar 

  11. Rubenstein EB, Peterson DE, Schubert M, Keefe D, McGuire D, Epstein J, Elting LS, Fox PC, Cooksley C, Sonis ST (2004) Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer 100 (Suppl 9):2026–2046

    Article  PubMed  Google Scholar 

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Authors and Affiliations

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

    Yoshinobu Aisa, Takehiko Mori, Akihiro Yokoyama, Yasuo Ikeda & Shinichiro Okamoto

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

    Masumi Kudo, Tomoko Yashima & Sakiko Kondo

Authors
  1. Yoshinobu Aisa
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  2. Takehiko Mori
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  3. Masumi Kudo
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  4. Tomoko Yashima
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  5. Sakiko Kondo
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  6. Akihiro Yokoyama
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  7. Yasuo Ikeda
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  8. Shinichiro Okamoto
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Corresponding author

Correspondence to Takehiko Mori.

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Aisa, Y., Mori, T., Kudo, M. et al. Oral cryotherapy for the prevention of high-dose melphalan-induced stomatitis in allogeneic hematopoietic stem cell transplant recipients. Support Care Cancer 13, 266–269 (2005). https://doi.org/10.1007/s00520-004-0726-y

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  • DOI: https://doi.org/10.1007/s00520-004-0726-y

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