Prospective Oral Mucositis Audit: Oral mucositis in patients receiving high-dose melphalan or BEAM conditioning chemotherapy - European blood and marrow transplantation mucositis advisory group
Prospective Oral Mucositis Audit: Oral mucositis in patients receiving high-dose melphalan or BEAM conditioning chemotherapy - European blood and marrow transplantation mucositis advisory group
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DOI：
10.1200/jco.2007.13.6028
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发表时间：
2008-03-20
影响因子：
45.3
通讯作者：
McCann, Shaun
中科院分区：
文献类型：
--
作者：
Blijlevens, Nicole;Schwenkglenks, Matthias;McCann, Shaun
目的：前瞻性口腔粘膜炎评估评估严重口腔粘膜炎的发病率、持续时间和决定因素（OM; WHO口服毒性量表3至4级）在自体干细胞移植前接受高剂量预处理化疗的多发性骨髓瘤（MM）或非霍奇金淋巴瘤（NHL）患者中的应用。（n = 109;平均年龄57 ± 8岁）或NHL（n = 88;平均年龄50 ± 13岁）接受大剂量美法仑治疗（200 mg/m2）或卡莫司汀300 mg/m2、依托泊苷800 mg/m2、阿糖胞苷800 - 1,600 mg/m2和美法仑140 mg/m2化疗。每天进行OM评估，直到移植后30天或出院。高质量的OM评估是通过强化培训计划来确保的。（95% CI，36%-56%），MM患者和42%（95% CI，32%至53%），平均持续时间分别为5.3天（95% CI，4.4至6.1天）和5.5天（95% CI，4.5至6.7天）。从预处理开始至OM评分达到峰值的时间分别为12.1 +/- 2.6和14.6 +/- 2.4天。严重OM的风险和/或持续时间显着相关，较高的化疗剂量每公斤体重和性能状态不佳，但与以前的一些报告相比，这是不相关的年龄。
PurposeThe Prospective Oral Mucositis Audit assessed the incidence, duration, and determinants of severe oral mucositis (OM; WHO oral toxicity scale grades 3 to 4) in patients with multiple myeloma (MM) or non-Hodgkin's lymphoma (NHL) receiving high-dose conditioning chemotherapy before autologous stem-cell transplantation.Patients and MethodsPatients with MM (n = 109; mean age, 57 +/- 8 years) or NHL (n = 88; mean age, 50 +/- 13 years) were treated with high-dose melphalan (200 mg/m(2)) or carmustine 300 mg/m(2), etoposide 800 mg/m(2), cytarabine 800 to 1,600 mg/m(2), and melphalan 140 mg/m(2) chemotherapy, respectively, in 25 European centers. OM assessments were made daily until 30 days after transplantation or hospital discharge. High quality of OM assessment was ensured by an intensive training program.ResultsSevere OM occurred in 46% (95% CI, 36% to 56%) of patients with MM and 42% (95% CI, 32% to 53%) of patients with NHL, with a mean duration of 5.3 days (95% CI, 4.4 to 6.1 days) and 5.5 days (95% CI, 4.5 to 6.7 days), respectively. Time from start of conditioning to peak OM score was 12.1 +/- 2.6 and 14.6 +/- 2.4 days. Severe OM risk and/or duration was significantly associated with higher chemotherapy dose per kilogram of body weight and poor performance status, but in contrast with some previous reports, this was not related to age.ConclusionSevere OM is more common in the transplantation setting than previously reported, justifying effective preventative and therapeutic measures.