Usefulness and safety of oral cryotherapy in the prevention of oral mucositis after conditioning regimens with high-dose melphalan for autologous stem cell transplantation for lymphoma and myeloma
Usefulness and safety of oral cryotherapy in the prevention of oral mucositis after conditioning regimens with high-dose melphalan for autologous stem cell transplantation for lymphoma and myeloma
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DOI：
10.1111/ejh.12386
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发表时间：
2014-12-01
影响因子：
3.1
通讯作者：
Ribera, Josep-Maria
中科院分区：
文献类型：
--
作者：
Batlle, Montserrat;Morgades, Mireia;Ribera, Josep-Maria
背景：口腔粘膜炎（OM）是大剂量美法仑（HDmel）预处理方案的常见并发症。这项回顾性队列研究分析了口腔冷冻疗法（OC）或室温生理盐水冲洗对预防多发性骨髓瘤（MM）或淋巴瘤患者OM的影响，这些患者在单中心接受自体干细胞移植（ASCT）。患者和方法：从2006年8月至2011年7月，连续134例患者入组。两个连续组包括：非OC（2006年8月至2009年4月，68例患者）和OC（2009年5月至2011年7月，66例病例）。MM患者（78例，58%）接受HDmel作为预处理方案，56例（42%）淋巴瘤患者接受BEAM。结果：非OC组和OC组的主要临床生物学特征和肿瘤类型相似。在接受BEAM作为预处理治疗的患者中，OM更频繁和严重。OC组的粘膜炎发生频率和严重程度较低，使用抗生素的天数较少。与OC组和非OC组相比，在OM持续时间、肠外营养和麻醉剂需求以及住院时间方面没有观察到差异。多因素分析显示，OC是影响OM发生的独立预后因素。结论：这项研究表明，在接受HDmel预处理方案进行ASCT的淋巴瘤和骨髓瘤患者中，OC在预防OM方面比生理盐水冲洗更有效。
Background: Oral mucositis (OM) is a common complication of conditioning regimens with high-dose melphalan (HDmel). This retrospective cohort study analyzes the impact of oral cryotherapy (OC) or room temperature saline rinses on the prevention of OM in patients with multiple myeloma (MM) or lymphoid neoplasias submitted to autologous stem cell transplantation (ASCT) in a single center. Patients and methods: From August 2006 to July 2011, 134 consecutive patients were enrolled. Two consecutive groups were included: Non-OC (August 2006 to April 2009, 68 patients) and OC (May 2009 to July 2011, 66 cases). MM cases (78, 58%) received HDmel as the conditioning regimen and 56 patients (42%) with lymphoma received BEAM. Results: The non-OC and OC groups were comparable for the main clinicobiologic features and type of neoplasia. OM was more frequent and severe in patients receiving BEAM as the conditioning therapy. The group of OC showed less frequent and less severe mucositis and fewer days on antibiotics. No differences were observed in the duration of OM, need for parenteral nutrition and narcotics, and the length of hospital stay on comparison with the OC and non-OC groups. By multivariate analyses, OC was an independent favorable prognostic factor for OM development. Conclusions: This study shows that OC is more effective than saline rinses in the prevention of OM in patients with lymphoma and myeloma receiving conditioning regimens with HDmel for ASCT.