Treating oral mucositis with a supersaturated calcium phosphate rinse: comparison with control in patients undergoing allogeneic hematopoietic stem cell transplantation

Abstract

Purpose Of patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT), 75 % or more experience oral mucositis, a painful acute complication that can delay discharge, interrupt treatment, and threaten life. To evaluate the efficacy of a supersaturated calcium phosphate rinse (SCPR), we compared it with customary care—topical mouth solutions—on measures of severity and consequent interventions and complications. Methods In this randomized controlled trial, 40 patients undergoing allogeneic HSCT were randomized: 20 to SCPR four times daily and 20 to solutions made with salvia leaf extract, iodine-povidine, and fluconazole. Treatment extended from initiation of conditioning treatment until the granulocyte count was ≥0.2 g/L. Mucositis severity was measured daily by a hematologist according to a World Health Organization (WHO) scale and self-assessed by patients. Need for interventions [analgesics, total parenteral nutrition (TPN), and granulocyte colony-stimulating factor] and complications (acute graft-versus-host disease and infections) were also assessed. Results In comparison with the control group, the SCPR group had significantly lower mean measures of WHO oral toxicity (0.9 vs. 1.8; P = 0.02), disease course (3.2 vs. 7.1 days; P = 0.02), and peak mouth pain (0.85 vs. 1.75; P = 0.005). Analgesic need was significantly shorter (1.1 vs. 3.4 days; P = 0.047) and the need for TPN significantly lower (0 vs. 6 patients; P = 0.02; 0 vs. 1.9 mean days; P = 0.009). Measures of complications were lower in the SCPR group, but not significantly so. Trial limitations include the impracticality of achieving double blinding with agents so different in appearance and in preadministration preparation. Conclusions Compared with the control group, the SCPR group had significantly lower mean measures of oral toxicity, peak mouth pain, and disease course duration. These results warrant confirmation in controlled, multicenter, randomized trials.

Class IV laser therapy as treatment for chemotherapy‐induced oral mucositis in onco‐haematological paediatric patients: a prospective study

“…Unfortunately, OM is associated with painful complications such as difficulty in swallowing, chewing and phonation, as well as to superinfections and sepsis. In the present study, the majority of patients (61%) suffered from difficulties in oral feeding and from pain due to the presence of ulcerations and erythema as well as from moderate to severe pain.…”

Use of Chamomilla recutita in the Prevention and Treatment of Oral Mucositis in Patients Undergoing Hematopoietic Stem Cell Transplantation

“…36 Another study used a supersaturated calcium phosphate rinse and had an average of 0.9 for the experimental group and of 1.8 for the control. 37 In terms of using C recutita to manage oral mucositis, we identified 3 studies in the literature with an experimental research design. In 1 of these studies, which used a quasi-experimental definition, a solution containing C recutita was probably effective in reducing the incidence and intensity of mucositis induced by chemotherapy and/or radiation therapy.…”

Calcium Orthophosphates (CaPo ) and Dentistry

“…To help the patients, rinses, supersaturated by undisclosed types of CaPO 4 , were prepared and evaluated. Compared to the control groups, the supersaturated CaPO 4 rinse groups were found to have significantly lower mean measures of oral toxicity, peak mouth pain and disease course duration [556][557][558][559].…”