Mucositis In Patients With Hematologic Malignancies: Prophylaxis Or Treatment - That Is The Question

• Published in: Blood 2013-11, Vol.122 (21), p.5618-5618
• Main Authors: Pereira, Dulcineia, Chacim, Sergio Pereira, Martinez, Jose, Mesquita, Edgar, Sousa, Ines, Martins, Angelo, Mariz, Jose Mario
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V122.21.5618.5618

Oral and gastrointestinal mucositis in the context of high dose chemotherapy (CT) and/or radiotherapy (RT) remains one of the most problematic side effects that influences  quality of life (QOL). Mucositis may lead to clinical deterioration with significant weight loss and reduction of chemotherapy doses with lower effectiveness, prolongation of hospitalization and increased costs. Epidemiological characterization of mucositis secondary to CT. Prognostic impact of the type of hematologic malignancy in the mucositis' risk. Impact of conservative treatment (MASCC/ISSO) in the risk of mucositis and hospitalization days. Observational study of sequencial 30 patients with acute leukemia (AL) and aggressive B-cell non-Hodgkin lymphoma (B-NHL), indicated for CT (1st or 2nd line), followed at our center between February and August 2012. Patients admitted to the study underwent daily assessment by trained nurse staff for the degree of mucositis (WHO), pain and diarrhea, according to well-established scales, and for the presence of neutrophils, need for analgesics, basic oral prophylactic care (BOC) - guidelines MASCC / ISSO - vs BOC and therapeutic treatment (Caphosol ® and/or Gelclair ®) of mucositis. The evaluation was carried out up to day 20th  of CT, or until mucositis resolved to grade ≤ 2 for 2 consecutive days or until day 12thof CT in patients who had mucositis ≤ grade 1. Patient characteristics were compared by the χ2 test for binary variables and by the Mann-Whitney test for continuous variables. Data was modeled according to longitudinal procedures, regarding continuous and multinomial dependent variables. We used R software with packages lme and VGAM. The remaining data were analyzed by using SPSS version 17.0. A p value less than 0,01 was considered to be statistically significant. 30 patientes were included, corresponding to 75 episodes/admissions of patients with hematologic malignancy, of which 22,7% (n = 17) developed mucositis. The median follow-up was 23 days (min.5-máx.35). 64,7% (n = 11) patients were diagnosed with AL and 35,3% (n = 6) patients diagnosed with Burkitt NHL, median age was 61 years (min.35-máx.68) and 41,5 years (min.37-máx.47), respectively. Regarding the treatment phase, 72,7% (n = 8) patients with AL were evaluated during induction, 18,2% (n = 2) during consolidation and 9,1% (n = 1) during aplasia. 33,3% (n = 2) patients with B-NHL were evaluated under CT and 66,7 (n = 4) under aplasia. Through the application of a multinomi