title: Etoposide induces more severe mucositis than CY when added to TBI as conditioning in allograft recipients receiving CsA and MTX.
abstract: Fractionated TBI and etoposide (FTBI-VP16) conditioning is effective therapy for patients receiving allogeneic stem cell transplants for ALL. One of the major dose-limiting toxicities with this regimen is mucositis although its effect on patients and hospital resources is not well described. To determine the severity of mucositis (WHO grade 3-4) experienced and assess resource utilisation, we compared the non-haematological toxicities of 38 patients receiving FTBI-VP16 with 104 patients receiving CY and TBI (CYTBI). FTBI-VP16 patients were more likely to develop severe mucositis (odds ratio (OR) 6.0 (95% confidence interval (CI) 1.36, 54.42), P<0.01) and its duration was longer (11.5 vs 8 days, P<0.01). Resource utilisation was considerably higher especially in the use and duration of i.v. narcotics and parenteral nutrition, nursing care requirements and plt-transfusion support. Patients receiving FTBI-VP16 conditioning are ideal candidates for new therapies to prevent or reduce the severity of mucositis.
authors.affiliation: Department of Clinical Haematology & BMT Service, The Royal Melbourne Hospital, Victoria, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Hoyt
authors.forename: D S
authors.initials: DS
authors.lastname: Ritchie
authors.forename: A
authors.initials: A
authors.lastname: Wirth
authors.forename: J
authors.initials: J
authors.lastname: Szer
authors.forename: A P
authors.initials: AP
authors.lastname: Grigg
mesh_terms: D000293:Adolescent; D000328:Adult; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D016572:Cyclosporine / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007938:Leukemia / Q000628:therapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D052016:Mucositis / Q000139:chemically induced*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D014184:Transplantation, Homologous; D014916:Whole-Body Irradiation / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D007166:Immunosuppressive Agents; D005047:Etoposide; D016572:Cyclosporine; D003520:Cyclophosphamide; D008727:Methotrexate