N. Di Renzo

A progression-risk score to predict treatment-free survival for early stage chronic lymphocytic leukemia patients

A progression-risk score to predict treatment-free survival for early stage chronic lymphocytic leukemia patients

Prevention of high dose melphalan-induced mucositis by cryotherapy in transplanted patients

8174 Background: Oral mucositis is a severe problem for patients (pts) undergoing high dose chemotherapy (HDC) followed by peripheral blood progenitor cells transplantation. Once mucositis has occurred, treatment consists of measures to palliate symptoms. Multiple agents have been used prophylactically to reduce this toxicity with discordant results. Oral cryotherapy, through vasoconstriction, can decrease the mucosal damage induced by agents with short half-lives, such as melphalan (L-PAM). Aim of this study was to evaluate the effect of local cryotherapy on oral mucositis in pts treated with high-dose (HD) L-PAM Methods: From December 2001, 23 pts (5 with multiple myeloma, 9 with non Hodgkins Lymphoma, 7 with breast cancer, 1 with ovarian cancer) underwent HDC including L-PAM; in particular, 5 pts received HD L-PAM (140-160 mg/m2) alone and 17 pts a L-PAM including conditioning regimen. All these pts were asked to suck on ice chips for 30 minutes, starting 5 minutes prior to the L-PAM infusion. These pts received also antimycotic and antibiotical prophylaxis with fluconazole 200 mg/d and ciprofloxacin 500 mgx2/d, respectively. RESULTS We observed oral mucositis (NCI-CTC) G0 2/22 pts (9%), G1 12/22 pts (55%), G2 3/22 pts (13%), G3 5/22 (23%) pts. CONCLUSIONS In our experience, the incidence of severe mucositis was significantly lower respect to historical data; so, the prophylaxis with cryotherapy should be considered in pts receiving high dose L-PAM. No significant financial relationships to disclose.