Oral Cryotherapy For The Prevention Of Mucositis Following Myeloablative Conditioning and Hematopoietic Stem Cell Transplantation

To investigate the effect of oral cryotherapy for the prevention of oral mucositis in recipients of Hematopoietic Stem Cell Transplantation(HSCT) after myeloablative conditioning and to specify its best timing and duration.

This study was a prospective randomized controlled clinical study, involving 37 patients from the bone marrow transplantation unit of the First Affiliated Hospital of Soochow University. In addition to the basic oral care given to all patients, study participants were divided into two experimental groups given oral cryotherapy and one control group. Optimal timing of the oral cryotherapy intervention was explored, based on pharmacokinetics of drug elimination. During the period of conditioning, experimental group 1(Exp.1) received oral cryotherapy from the beginning of drug infusion continuously until the end of drug infusion; experimental group 2 (Exp.2) received oral cryotherapy starting half way through the infusion of the drug. The rate and severity of mucositis was evaluated according to the National Cancer Institute-Common Toxicity Criteria. Data were then analyzed using SPSS15.0.

Oral mucositis occurred on cheeks (43.9%), tongue (27.57%) and lips (15.7%). There was no difference regarding the incidence of severe mucositis ≥ Grade 3 (33% in Exp.1 group, 15% in Exp.2 group, and 25% in the control group, p = ns) and its duration (8 days in Exp.1 group, 2.5 days in Exp.2 group, and 7 days in the control group, p = ns). However, the frequency of vomiting episodes was significantly reduced in Exp.2 with 10 episodes (2-28) versus 21 (2-60) in the control group (p=0.01) and 12.5 (2-39) in exp 1. [Conclusions] A short duration of oral cryotherapy beginning at midpoint of infusing the chemotherapy schedule significantly reduced vomiting associated with myeloablative conditioning. These preliminary results in view of the low statistical power of the study justify further trials.

No relevant conflicts of interest to declare.