Measuring mucosal damage induced by cytotoxic therapy.
We scored oral mucositis and gut toxicity and measured sugar permeability testing among 56 recipients of a haematopoietic stem cell transplant (HSCT) given myeloablative conditioning with idarubicin, cyclophosphamide and TBI, and a group of 18 patients given cytotoxic chemotherapy for newly diagnosed acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS). Gut integrity was already disturbed in the AML/MDS group as measured by the lactulose/rhamnose ratio (L/R ratio=0.09) before therapy and was severely perturbed (L/R ratio >0.13) for a month after HSCT. Oral mucositis and to a lesser extent gut toxicity was only significantly correlated with disturbed permeability in the transplant group. The data suggest that sugar permeability, oral mucositis and gut toxicity measure different features of mucosal damage after intensive cytotoxic therapy.
Blijlevens
N M A
NM
Department of Haematology, University Medical Centre St. Radboud Nijmegen, PO Box 9101, 6500 HB Wageningen, The Netherlands. N.Blijlevens@hemat.umcn.nl
van't Land
B
B
Donnelly
J P
JP
M'Rabet
L
L
de Pauw
B E
BE
D019325:3-O-Methylglucose / Q000493:pharmacokinetics; D000208:Acute Disease; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects*; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects; D003520:Cyclophosphamide / Q000009:adverse effects; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects* / Q000528:radiation effects; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015255:Idarubicin / Q000009:adverse effects; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000528:radiation effects; D007792:Lactulose / Q000493:pharmacokinetics; D007951:Leukemia, Myeloid / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects* / Q000528:radiation effects; D009190:Myelodysplastic Syndromes / Q000628:therapy; D010539:Permeability; D012210:Rhamnose / Q000493:pharmacokinetics; D013280:Stomatitis / Q000139:chemically induced / Q000209:etiology; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014916:Whole-Body Irradiation; D014994:Xylose / Q000493:pharmacokinetics
D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D019325:3-O-Methylglucose; D007792:Lactulose; D003520:Cyclophosphamide; D014994:Xylose; D012210:Rhamnose; D015255:Idarubicin