The Prospective Oral Mucositis Audit: relationship of severe oral mucositis with clinical and medical resource use outcomes in patients receiving high-dose melphalan or BEAM-conditioning chemotherapy and autologous SCT.
The Prospective Oral Mucositis Audit was an observational study in 197 patients with multiple myeloma (MM) or non-Hodgkin's lymphoma (NHL) undergoing, respectively, high-dose melphalan or BEAM chemotherapy and autologous SCT at 25 European centres. We evaluated the relationship between severe oral mucositis (SOM; WHO Oral Toxicity Scale grade 3-4) and local and systemic clinical sequelae and medical resource use. SOM occurred in 44% of patients. The duration of SOM (mean 5.3 days) correlated with time to neutrophil engraftment. The following parameters increased gradiently with maximum grade of oral mucositis: duration of pain score >or=4, opioid use, dysphagia score >or=4, total parenteral nutrition (TPN) use, incidence and/or duration of fever and infection, and duration of antibiotic use. SOM increased the duration of TPN use by 2.7 days (P<0.001), opioids by 4.6 days (P<0.001), and antibiotics by 2.4 days (P=0.045). SOM prolonged hospital stay by 2.3 days (P=0.013) in MM patients, but not in NHL patients (who tended to have a longer hospital stay). In conclusion, this analysis of prospectively collected observational data provides important insight into the scope and impact of SOM in the European transplant setting.
McCann
S
S
Department of Haematology, St James's Hospital, Dublin, Ireland. smccann@stjames.ie
Schwenkglenks
M
M
Bacon
P
P
Einsele
H
H
D'Addio
A
A
Maertens
J
J
Niederwieser
D
D
Rabitsch
W
W
Roosaar
A
A
Ruutu
T
T
Schouten
H
H
Stone
R
R
Vorkurka
S
S
Quinn
B
B
Blijlevens
N
N
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007902:Length of Stay; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008485:Medical Audit; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D033581:Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D013280:Stomatitis / Q000139:chemically induced / Q000209:etiology*; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods
D000701:Analgesics, Opioid; D000900:Anti-Bacterial Agents; D003561:Cytarabine; D005047:Etoposide; D008558:Melphalan; D002330:Carmustine