title: Oral mucositis and outcomes of allogeneic hematopoietic stem-cell transplantation in patients with hematologic malignancies.
abstract: OBJECTIVE
  To assess the relationship between oral mucositis (OM) and adverse clinical and economic outcomes in patients with hematologic malignancies receiving allogeneic hematopoietic stem-cell transplantation (HSCT).
  
  
  METHODS
  A retrospective chart review study of 281 allogeneic HSCT recipients with hematologic malignancies was undertaken at a single academic center. OM extent and severity were assessed across eight oropharyngeal sites using a validated scale, which was scored as follows: no erythema/ulceration=0; erythema only=I; ulceration, one site=II; ulceration, two sites=III; ulceration, three sites=IV and ulceration, four or more sites=V. OM assessments began on the day of conditioning and continued twice weekly within 28 days or hospital discharge. Analyses examined the relationship between the worst OM grade and selected adverse outcomes, including days with fever, days of total parenteral nutrition (TPN), days of parenteral narcotic therapy, incidence of significant (common terminology criteria (CTC) grade 3 or 4) infection, mortality and inpatient days and charges.
  
  
  RESULTS
  The mean age of the study subjects was 41 years. Of the patients, 96% (n = 269) received total body irradiation and 76% (n = 214) experienced an OM grade of > or =II (i.e., ulceration). The worst OM grade was significantly (p < 0.05) associated with the number of days of TPN and parenteral narcotic therapy, number of days with fever, incidence of significant infection, time in hospital and total inpatient charges.
  
  
  CONCLUSIONS
  OM is associated with worse clinical and economic outcomes in patients with hematologic malignancies undergoing allogeneic HSCT.
authors.affiliation: Policy Analysis Incorporated, Four Davis Court, Brookline, MA 02445, USA.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Vera-Llonch
authors.forename: Gerry
authors.initials: G
authors.lastname: Oster
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Ford
authors.forename: John
authors.initials: J
authors.lastname: Lu
authors.forename: Stephen
authors.initials: S
authors.lastname: Sonis
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D001900:Boston; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D012189:Retrospective Studies; D013280:Stomatitis / Q000139:chemically induced* / Q000191:economics; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents