Palifermin for prevention of oral mucositis after haematopoietic stem cell transplantation- single centre experience.
OBJECTIVE
Oral mucositis (OM) is one of the most debilitating and common side effects in patients treated with high-dose chemotherapy supported by haematopoietic stem cell transplantation (HSCT). We tested the effectiveness of palifermin to avoid oral mucosal injury induced by the conditioning regimen.


METHODS
Twenty patients with haematological malignancies were treated with palifermin for prevention of OM during HSCT procedures. Nine patients received allogeneic haematopoietic stem cells, and in 11 autologous HSCT was performed. The control group was composed of patients who had been treated with HSCT previously, before the palifermin era. The source of graft was peripheral blood.


RESULTS
Among patients treated with palifermin no grade 2-4 OM was observed. No patient had to receive opioid analgesics or total parenteral nutrition. 30% of the patients developed grade 1 OM of 4-5 days' duration. In the control group OM was observed in all cases, with 50% of the patients developing grade 3-4 OM. Median duration of OM was 10 and 12 days for auto- and allogeneic patients, respectively. In comparison with the control group, treatment with palifermin was associated with significant reduction of grade 2-4 OM, shorter duration of OM, less analgesics intake, and reduced number of days with antibiotic treatment. Additionally, allogeneic patients treated with palifermin had shorter time to platelet engraftment.


CONCLUSIONS
Palifermin reduces incidence, severity and duration of OM, and decreases the number of days with analgesics and antibiotics. For allogeneic patients it can shorten the time to platelet engraftment, but this observation needs further studies.
Rzepecki
P
P
Bone Marrow Transplantation Unit, Department of Oncology, Central Hospital, Military Institute of Health Services, Warsaw, Poland. piotr_rzepecki@poczta.onet.pl
Sarosiek
T
T
Barzal
J
J
Oborska
S
S
Nurzynski
P
P
Wasko
A
A
Szczylik
C
C
D000328:Adult; D005260:Female; D051523:Fibroblast Growth Factor 7 / Q000627:therapeutic use*; D019337:Hematologic Neoplasms / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D013280:Stomatitis / Q000139:chemically induced / Q000517:prevention & control*; D019172:Transplantation Conditioning / Q000009:adverse effects*; D016896:Treatment Outcome
D051523:Fibroblast Growth Factor 7