Severe oral mucositis is a major cause of morbidity following allogeneic hematopoietic stem cell transplantation (AHSCT). Cryotherapy, that is, the application of ice chips on the mucosa of the oral cavity during the administration of antineoplastic agents, may reduce the incidence and severity of chemotherapy-related oral mucositis. In this multicenter randomized study, we addressed whether cryotherapy during MTX administration is effective in the prevention of severe oral mucositis in patients undergoing myeloablative AHSCT. One hundred and thirty patients undergoing myeloablative AHSCT and MTX-containing GVHD prophylaxis were enrolled and randomized to receive or not receive cryotherapy during MTX administration. The incidence of severe (grade 3-4) oral mucositis, the primary end point of the study, was comparable in patients receiving or not cryotherapy. Moreover, no difference was observed in the incidence of oral mucositis grade 2-4 and the duration of oral mucositis grade 3-4 or 2-4, or in the kinetics of mucositis over time. In univariate and multivariate analysis, severe oral mucositis correlated with TBI in the conditioning regimen and lack of folinic acid rescue following MTX administration. Thus, cryotherapy during MTX administration does not reduce severe oral mucositis in patients undergoing myeloablative allogeneic HSCT. Future studies will assess cryotherapy before allogeneic HSCT.

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Self-control failure has enormous personal and societal consequences. One of the most debated models explaining why self-control breaks down is the Strength Model, according to which self-control depends on a limited resource. Either previous acts of self-control or taking part in highly demanding cognitive tasks have been shown to reduce self-control, possibly due to a reduction in blood glucose levels. However, several studies yielded negative findings, and recent meta-analyses questioned the robustness of the depletion effect in humans. We investigated, for the first time, whether the Strength Model applies to a non-human primate species, the tufted capuchin monkey. We tested five capuchins in a self-control task (the Accumulation task) in which food items were accumulated within individual’s reach for as long as the subject refrained from taking them. We evaluated whether capuchins’ performance decreases: (i) when tested before receiving their daily meal rather than after consuming it (Energy Depletion Experiment), and (ii) after being tested in two tasks with different levels of cognitive complexity (Cognitive Depletion Experiment). We also tested, in both experiments, how implementing self-control in each trial of the Accumulation task affected this capacity within each session and/or across consecutive sessions. Repeated acts of self-control in each trial of the Accumulation task progressively reduced this capacity within each session, as predicted by the Strength Model. However, neither experiencing a reduction in energy level nor taking part in a highly demanding cognitive task decreased performance in the subsequent Accumulation task. Thus, whereas capuchins seem to be vulnerable to within-session depletion effects, to other extents our findings are in line with the growing body of studies that failed to find a depletion effect in humans. Methodological issues potentially affecting the lack of depletion effects in capuchins are discussed.

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