title: Oral cryotherapy for the prevention of high-dose melphalan-induced stomatitis in allogeneic hematopoietic stem cell transplant recipients.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of oral cryotherapy to prevent high-dose melphalan-induced stomatitis.
  
  
  METHODS
  Eighteen consecutive recipients of allogeneic hematopoietic stem cell transplant conditioned with high-dose melphalan (140 mg/m2) in combination with fludarabine alone or with fludarabine and additional chemotherapy or radiation were enrolled. The severity of stomatitis was graded according to the National Cancer Institute Common Toxicity Criteria. Patients were kept on oral cryotherapy using ice chips and ice-cold water shortly before, during, and for additional 90 min after completion of melphalan administration.
  
  
  RESULTS
  Only two of 18 patients (11.1%) developed grade 2 or 3 stomatitis while six of seven patients in the historical control developed it (85.7%; P=0.001).
  
  
  CONCLUSIONS
  These results suggested that oral cryotherapy could effectively prevent stomatitis caused by high-dose melphalan, and we recommend that it should be incorporated into the conditioning regimen with high-dose melphalan.
authors.affiliation: Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Aisa
authors.forename: Takehiko
authors.initials: T
authors.lastname: Mori
authors.forename: Masumi
authors.initials: M
authors.lastname: Kudo
authors.forename: Tomoko
authors.initials: T
authors.lastname: Yashima
authors.forename: Sakiko
authors.initials: S
authors.lastname: Kondo
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yokoyama
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Okamoto
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects*; D017679:Cryotherapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007564:Japan; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D013280:Stomatitis / Q000139:chemically induced* / Q000517:prevention & control*
chemical_list: D018906:Antineoplastic Agents, Alkylating; D008558:Melphalan