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A comparison of oral mucositis in allogeneic hematopoietic stem cell transplantation between conventional and reduced-intensity regimens
Authors:Haruhiko Kashiwazaki  Takae Matsushita  Junichi Sugita  Akio Shigematsu  Kumiko Kasashi  Yutaka Yamazaki  Takashi Kanehira  Takeshi Kondo  Tomoyuki Endo  Junji Tanaka  Satoshi Hashino  Mitsufumi Nishio  Masahiro Imamura  Yoshimasa Kitagawa  Nobuo Inoue
Institution:1. Gerodontology, Division of Oral Health Science, Hokkaido University Graduate School of Dental Medicine, Kita-13 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060–8586, Japan
2. Stem Cell Transplantation Center, Hokkaido University Hospital, Kita-14 Nishi-5, Kita-ku, Sapporo, 060–8648, Japan
3. Division of Pharmacy, Hokkaido University Hospital, Kita-14 Nishi-5, Kita-ku, Sapporo, 060–8648, Japan
4. Oral Diagnosis and Oral Medicine, Division of Oral Pathobiological Science, Hokkaido University Graduate School of Dental Medicine, Kita-13 Nishi-7, Kita-ku, Sapporo, 060–8586, Japan
5. Preventive Dentistry, Division of Oral Health Science, Hokkaido University Graduate School of Dental Medicine, Kita-13 Nishi-7, Kita-ku, Sapporo, 060–8586, Japan
Abstract:Severe oral mucositis developed in allogeneic hematopoietic stem cell transplantation (HSCT) accompanies intolerable pain and risk for systemic bacteremia infection. Conventional stem cell transplantation (CST) and reduced-intensity regimens for allogeneic HSCT (RIST) may differently affect the occurrence and severity of oral mucositis. Here, we comparatively examined oral mucositis in patients undergoing CST and that in RIST patients to search for measures to alleviate oral mucositis. We retrospectively analyzed the data of 130 consecutive patients undergoing HSCT (conventional, 60; RIST, 70). Oral mucositis was evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. We also investigated the risk factors for severe oral mucositis in each regimen. The incidence of oral mucositis was not significantly different between RIST and CST patients. The use of opioid analgesics to control pain due to oral mucositis was significantly less in patients undergoing RIST compared with those receiving CST. The risk factors for severe oral mucositis, determined by univariate and multivariate analyses, were “younger age (<40)” in CST and “longer duration of neutropenia (≥14?days)” in RIST. Although the incidences of oral mucositis were almost the same, the need for opioid analgesics and the risk factors for severe oral mucositis differed between CST and RIST patients.
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