title: NASA light-emitting diodes for the prevention of oral mucositis in pediatric bone marrow transplant patients.
abstract: OBJECTIVE
  The purpose of this study was to determine the effects of prophylactic near-infrared light therapy from light-emitting diodes (LEDs) in pediatric bone marrow transplant (BMT) recipients.
  
  
  BACKGROUND
  Oral mucositis (OM) is a frequent side effect of chemotherapy that leads to increased morbidity. Near-infrared light has been shown to produce biostimulatory effects in tissues, and previous results using near-infrared lasers have shown improvement in OM indices. However, LEDs may hold greater potential for clinical applications.
  
  
  METHODS
  We recruited 32 consecutive pediatric patients undergoing myeloablative therapy in preparation for BMT. Patients were examined by two of three pediatric dentists trained in assessing the Schubert oral mucositis index (OMI) for left and right buccal and lateral tongue mucosal surfaces, while the patients were asked to rate their current left and right mouth pain, left and right xerostomia, and throat pain. LED therapy consisted of daily treatment at a fluence of 4 J/cm(2) using a 670-nm LED array held to the left extraoral epithelium starting on the day of transplant, with a concurrent sham treatment on the right. Patients were assessed before BMT and every 2-3 days through posttransplant day 14. Outcomes included the percentage of patients with ulcerative oral mucositis (UOM) compared to historical epidemiological controls, the comparison of left and right buccal pain to throat pain, and the comparison between sides of the buccal and lateral tongue OMI and buccal pain.
  
  
  RESULTS
  The incidence of UOM was 53%, compared to an expected rate of 70-90%. There was also a 48% and 39% reduction of treated left and right buccal pain, respectively, compared to untreated throat pain at about posttransplant day 7 (p < 0.05). There were no significant differences between sides in OMI or pain.
  
  
  CONCLUSIONS
  Although more studies are needed, LED therapy appears useful in the prevention of OM in pediatric BMT patients.
authors.affiliation: Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. hwhelan@mcw.edu
authors.forename: Harry T
authors.initials: HT
authors.lastname: Whelan
authors.forename: James F
authors.initials: JF
authors.lastname: Connelly
authors.forename: Brian D
authors.initials: BD
authors.lastname: Hodgson
authors.forename: Lori
authors.initials: L
authors.lastname: Barbeau
authors.forename: A Charles
authors.initials: AC
authors.lastname: Post
authors.forename: George
authors.initials: G
authors.lastname: Bullard
authors.forename: Ellen V
authors.initials: EV
authors.lastname: Buchmann
authors.forename: Mary
authors.initials: M
authors.lastname: Kane
authors.forename: Noel T
authors.initials: NT
authors.lastname: Whelan
authors.forename: Ann
authors.initials: A
authors.lastname: Warwick
authors.forename: David
authors.initials: D
authors.lastname: Margolis
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007259:Infrared Rays / Q000627:therapeutic use*; D008027:Light; D008297:Male; D009061:Mouth Mucosa / Q000528:radiation effects; D013280:Stomatitis / Q000517:prevention & control*; D019172:Transplantation Conditioning / Q000379:methods*; D016896:Treatment Outcome