title: A multivariable analysis of factors influencing mucositis after autologous progenitor cell transplantation.
abstract: Mucositis is a common and vexing complication of autologous progenitor cell transplantation (ABMT). A modified oral mucositis assessment scale (OMAS) has been found to be a reproducible and effective tool for monitoring mucositis after radiation therapy or chemotherapy. We utilized the modified OMAS scale to study clinical parameters associated with the development of mucositis in 79 patients undergoing ABMT. Median patient age was 52; 61% had non-Hodgkin's lymphoma (NHL), 23% multiple myeloma and 14% Hodgkin's disease. Patients were mobilized with G-CSF alone or the combination of etoposide plus G-CSF. Univariable correlates of worse mucositis were prior radiation therapy (P = 0.004), a diagnosis of NHL (P = 0.014), progenitor cell mobilizing regimen containing etoposide (P = 0.001), and ABMT preparative regimen containing etoposide (P = 0.006). Multivariable regression analysis revealed that NHL diagnosis (P = 0.007), prior radiation therapy (P = 0.001), and etoposide in the mobilizing regimen (P = 0.034) were associated with worse post-transplant mucositis. Worsening mucositis correlated with a longer inpatient length of stay. We conclude that several variables contribute to worsening mucositis during autologous transplantation, including etoposide in the progenitor cell mobilizing regimen.
authors.affiliation: Department of Hematology and Medical Oncology, Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Bolwell
authors.forename: M
authors.initials: M
authors.lastname: Kalaycio
authors.forename: R
authors.initials: R
authors.lastname: Sobecks
authors.forename: S
authors.initials: S
authors.lastname: Andresen
authors.forename: E
authors.initials: E
authors.lastname: Kuczkowski
authors.forename: L
authors.initials: L
authors.lastname: Bernhard
authors.forename: R
authors.initials: R
authors.lastname: Lomax
authors.forename: J
authors.initials: J
authors.lastname: Kohuth
authors.forename: S
authors.initials: S
authors.lastname: Mendiola
authors.forename: L
authors.initials: L
authors.lastname: Rybicki
authors.forename: B
authors.initials: B
authors.lastname: Pohlman
mesh_terms: D005047:Etoposide / Q000009:adverse effects; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa; D015999:Multivariate Analysis; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012307:Risk Factors; D013280:Stomatitis / Q000453:epidemiology / Q000209:etiology*; D014182:Transplantation, Autologous
chemical_list: D005047:Etoposide