Prospective evaluation of clinical symptoms of chemotherapy‐induced oral mucositis in adult patients with acute leukemia: A preliminary study

Lee, Yeon Hee; Hong, Junshik; Kim, Inho; Choi, Youngnim; Park, Hee Kyung

doi:10.1002/cre2.253

Cited by 13 publications

(18 citation statements)

References 43 publications

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“…In our series, we found a correlation between mucositis and type of therapy [Intensive chemotherapy 20 (27%); non-intensive treatment 4 (14%); support care 2 (7%); p=0.04; in line with literature data, indicating a mucositis incidence of 20-40% in patients receiving standard chemotherapy and <5% receiving CPX-351 [23][24][25] ]. However, this is not reflected in the correlation between the type of therapy and MDRO colonization (p=0.2).…”

Section: Methodssupporting

confidence: 89%

Fever of Unknown Origin and Multidrug-Resistant Organisms Colonization in Aml Patients.

Guarnera

Trotta

Boldrini

et al. 2023

Mediterr J Hematol Infect Dis

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Abstract. Background: Colonization by multidrug-resistant organisms (MDRO) is a frequent complication in hematologic departments, which puts patients at risk of life-threatening bacterial sepsis. Fever of unknown origin (FUO) is a condition related to the delivery of chemotherapy in hematologic malignancies, in which the use of antibiotics is debated. The incidence, risk factors, and influence on the outcome of these conditions in patients with acute myeloid leukemia (AML) are not clearly defined.Methods: We retrospectively analyzed 132 consecutive admissions of non-promyelocytic AML patients at the Hematology Unit of the University Tor Vergata in Rome between June 2019 and February 2022. MDRO swab-based screening was performed in all patients on the day of admission and once weekly after that. FUO was defined as fever with no evidence of infection.Results: Of 132 consecutive hospitalizations (69 AML patients), MDRO colonization was observed in 35 cases (26%) and resulted independently related to a previous MDRO colonization (p=0.001) and length of hospitalization (p=0.03). The colonization persistence rate in subsequent admissions was 64%. MDRO-related bloodstream infection was observed in 8 patients (23%) and correlated with grade III/IV mucositis (p=0.008) and length of hospitalization (p=0.02). FUO occurred in 68 cases (51%) and correlated with an absolute neutrophilic count <500μ/L at admission (0.04).Conclusion: In our experience, MDRO colonization is a frequent and difficult-to-eradicate condition that can arise at all stages of treatment. Prompt discharge of patients as soon as clinical conditions allow could limit the spread of MDRO. In addition, the appropriate use of antibiotics, especially in the case of FUO, and the contraction of hospitalization length, when feasible, are measures to tackle the further spread of MDRO.

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Section: Methodssupporting

confidence: 89%

Fever of Unknown Origin and Multidrug-Resistant Organisms Colonization in Aml Patients.

Guarnera

Trotta

Boldrini

et al. 2023

Mediterr J Hematol Infect Dis

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“…In this study, the WHO classification was used to select patients, which is a combination of objective criteria such as mucosal changes including redness and ulcers and functional criteria such as inability to eat. Studies have shown that this criterion is significantly correlated with the clinical signs and symptoms of mucositis ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Mouthwash Containing Vitamin E, Triamcinolon, and Hyaluronic Acid Compared to Triamcinolone Mouthwash Alone in Patients With Radiotherapy-Induced Oral Mucositis: Randomized Clinical Trial

et al. 2021

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One of the most common side effects of radiotherapy in head and neck cancers is mucositis. Despite all the studies conducted on new therapies proposed for oral mucositis caused by radiation therapy, a single standard treatment strategy has not been developed yet. In the present study, for the first time, the effectiveness of the treatment with a combined mouthwash containing vitamin E (as an antioxidant), triamcinolone (as an anti-inflammatory agent) and hyaluronic acid (HA) (as a local reducer used for reducing the effects of ROS on the mucosa, with ameliorative effects (improving the healing process) compared to triamcinolone mouthwash alone was investigated in patients with radiotherapy-induced oral mucositis. This study was a randomized triple-blind clinical trial performed on 60 patients underwent radiotherapy on an outpatient basis. The combined mouthwash containing vitamin E, triamcinolone, and hyaluronic acid compared to triamcinolone mouthwash alone was prescribed for 4 weeks. The severity of oral mucositis was assessed based on the WHO classification and the intensity of pain was assessed using the numerical pain intensity scale. According to the analysis performed in the first, second, third and fourth weeks, the reduction of oral mucositis grade in the intervention group was significantly higher than in the comparison group. In the first, second, third, and fourth weeks, the reduction in pain intensity in the intervention group was significantly higher than in the comparison group (P < 0.001). The combined mouthwash containing vitamin E, hyaluronic acid and triamcinolone acetonide can be used as an effective treatment for oral mucositis caused by radiation therapy, which is probably the result of antioxidant, anti-inflammatory and improved healing process mechanisms due to the biological nature of the components of this mouthwash.Trial registrationThis study was registered in the WHO Primary registry (IRCT) with the code IRCT20190428043407N. Registered on 20 July 2019, https://www.irct.ir/trial/39231.

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“…Buccal mucosa, lips, soft palate, and the ventral side of the tongue as well as floor of the oral cavity are usually affected [31]. According to the World Health Organization (WHO) criteria for the assessment of toxic effects of cytostatics on oral tissues, mucositis is defined from individual painless ulceration to highly prominent erythema and edema of oral mucosa with multiple, extremely painful ulcerations that require the application of enteral or total parenteral nutrition [27,32,33]. Mucositis is more common in young people due to increased mitotic activity of oral epithelial cells in younger age.…”

Section: Oral Changes Before Transplantation Of Hematopoietic Stem Cellmentioning

confidence: 99%

Oral changes in patients before and after transplantation of solid organs and hematopoietic stem cells

et al. 2021

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Introduction/Objective. The aim of this paper is to point out the prevalence and severity of oral diseases in patients in the period before and after the transplantation of solid organs and hematopoietic stem cells. Methods. MEDLINE literature search was done via PubMed. Results. The development and improvement of transplantation medicine in specialized centers lead to an increasing number of patients, both adults and children, with transplanted solid organs and hematopoietic stem cells. Despite the success of therapy, numerous changes and complications can be observed on other organs in patients undergoing transplantation of solid organs and hematopoietic stem cells in the pre and post-transplant phase. Systemic diseases and conditions related to organ and cell transplantation, which are accompanied by numerous oral manifestations. The most common oral changes are gingival enlargement, desquamation of the oral epithelium, very painful ulcerations, polypoid and granulomatous changes in the oral mucosa, hard dental tissues with frequent complications, developmental anomalies of teeth in younger children, and in the later stage also the occurrence of oral cancer. After transplantation of solid organs and hematopoietic changes in the oral cavity and other organs occur depending on the patient?s post- transplantation period as well as on the applied immunosuppressive therapy. Conclusion. Oral changes development pre and post transplantation of solid organ and hematopoietic stem cells points to the importance of timely and good cooperation between the dentist and the doctor who treats the underlying disease.

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Prospective evaluation of clinical symptoms of chemotherapy‐induced oral mucositis in adult patients with acute leukemia: A preliminary study

Cited by 13 publications

References 43 publications

Fever of Unknown Origin and Multidrug-Resistant Organisms Colonization in Aml Patients.

Fever of Unknown Origin and Multidrug-Resistant Organisms Colonization in Aml Patients.

Mouthwash Containing Vitamin E, Triamcinolon, and Hyaluronic Acid Compared to Triamcinolone Mouthwash Alone in Patients With Radiotherapy-Induced Oral Mucositis: Randomized Clinical Trial

Oral changes in patients before and after transplantation of solid organs and hematopoietic stem cells

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