Palifermin improves severe mucositis, swallowing problems, nutrition impact symptoms, and length of stay in patients undergoing hematopoietic stem cell transplantation.
OBJECTIVE
The aim of this study was to compare palifermin, a recombinant form of human keratinocyte growth factor, with standard treatment on outcomes in patients receiving a high dose of chemotherapy conditioning regimen, undergoing hematopoietic stem cell transplantation (HSCT).


METHODS
Over a 1-year period, a series of 59 patients were included: 32 patients (palifermin) were compared with 27 patients (standard treatment). Outcomes assessed at day 8 posttransplantation were mucositis, swallowing, nutrition impact symptoms, dietary intake, time to engraftment, length of stay, infection, and cumulative dose and duration of narcotic administration.


RESULTS
There was a significant reduction in the incidence of severe oral mucositis (13 vs 48%, p=0.003), swallowing problems (p=0.044), number of nutrition impact symptoms experienced (4.9 vs 6.0, p=0.003), and length of stay (14 vs 18 days, p=0.026) in the palifermin group compared to standard care. There was no significant difference in infection, dietary intake, time to engraftment or cumulative dose and duration of narcotic administration between groups.


CONCLUSIONS
Beneficial outcomes were observed from the use of palifermin in patients undergoing HSCT after a high dose of chemotherapy conditioning regimen. A randomized clinical trial is needed to confirm these results.
Horsley
Pamela
P
The Wesley Hospital, Toowong, Queensland, 4066, Australia.
Bauer
Judith D
JD
Mazkowiack
Rachael
R
Gardner
Raeina
R
Bashford
John
J
D003680:Deglutition Disorders / Q000188:drug therapy* / Q000209:etiology; D002149:Energy Intake / Q000187:drug effects; D005260:Female; D051523:Fibroblast Growth Factor 7 / Q000494:pharmacology / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000188:drug therapy* / Q000209:etiology; D009294:Narcotics / Q000008:administration & dosage*; D009752:Nutritional Status / Q000187:drug effects
D009294:Narcotics; D051523:Fibroblast Growth Factor 7