title: 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.
abstract: 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.
authors.affiliation: Department of Haematology, St James's Hospital, Dublin, Ireland. smccann@stjames.ie
authors.forename: S
authors.initials: S
authors.lastname: McCann
authors.forename: M
authors.initials: M
authors.lastname: Schwenkglenks
authors.forename: P
authors.initials: P
authors.lastname: Bacon
authors.forename: H
authors.initials: H
authors.lastname: Einsele
authors.forename: A
authors.initials: A
authors.lastname: D'Addio
authors.forename: J
authors.initials: J
authors.lastname: Maertens
authors.forename: D
authors.initials: D
authors.lastname: Niederwieser
authors.forename: W
authors.initials: W
authors.lastname: Rabitsch
authors.forename: A
authors.initials: A
authors.lastname: Roosaar
authors.forename: T
authors.initials: T
authors.lastname: Ruutu
authors.forename: H
authors.initials: H
authors.lastname: Schouten
authors.forename: R
authors.initials: R
authors.lastname: Stone
authors.forename: S
authors.initials: S
authors.lastname: Vorkurka
authors.forename: B
authors.initials: B
authors.lastname: Quinn
authors.forename: N
authors.initials: N
authors.lastname: Blijlevens
mesh_terms: 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
chemical_list: D000701:Analgesics, Opioid; D000900:Anti-Bacterial Agents; D003561:Cytarabine; D005047:Etoposide; D008558:Melphalan; D002330:Carmustine