title: Role of antioxidants in buccal mucosa cells and plasma on the incidence and severity of oral mucositis after allogeneic haematopoietic cell transplantation.
abstract: OBJECTIVE
  Oral mucositis (OM) is known to be a significant complication of chemotherapy preceding haematopoietic cell transplantation (HCT). Antioxidants (AOX) scavenge free radicals, which play a major role in the initiation of OM and may reduce the OM risk.
  
  
  METHODS
  The primary objective of this prospective study was to investigate the association between the incidence and severity of OM (WHO oral toxicity scale) and the AOX status in buccal mucosa cells (BMC) and plasma. The α-tocopherol, ascorbic acid and ß-carotene concentrations in BMC and plasma were assessed at admission in 70 patients with a median age of 58 years before undergoing allogeneic HCT.
  
  
  RESULTS
  Severe OM (III-IV), ulcerative OM (II-IV) and no or mild OM (0-I) were documented in 14 (20.0%), 32 (45.7%) and 38 (54.3%) patients, respectively. We observed no significant differences in baseline AOX concentrations in plasma or BMC among the OM groups. However, between patients with at least one plasma AOX beneath the normal range (39/70) and those with all plasma AOX in the normal range (31/70), we noted a trend towards longer duration of parenteral nutrition (PN) during the study period (10 vs. 8 days; p = 0.066).
  
  
  CONCLUSIONS
  No single AOX, either in plasma or BMC (α-tocopherol, ascorbic acid and ß-carotene), revealed predictive value for the incidence or severity of OM. However, patients with an overall good plasma AOX status tended to require less PN, a common clinical marker for OM, which may be more relevant than any one AOX at reducing the risk of OM.
authors.affiliation: Department of Haematology/Oncology, Section of Nutrition, Albert Ludwigs-University Medical Center Freiburg, Hugstetter Str 55, 79106, Freiburg, Germany. paul.urbain@uniklinik-freiburg.de
authors.forename: Paul
authors.initials: P
authors.lastname: Urbain
authors.forename: Anna
authors.initials: A
authors.lastname: Raynor
authors.forename: Hartmut
authors.initials: H
authors.lastname: Bertz
authors.forename: Christine
authors.initials: C
authors.lastname: Lambert
authors.forename: Hans-Konrad
authors.initials: HK
authors.lastname: Biesalski
mesh_terms: D000328:Adult; D000368:Aged; D001205:Ascorbic Acid / Q000097:blood / Q000378:metabolism*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000166:cytology*; D009369:Neoplasms / Q000378:metabolism / Q000628:therapy*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013280:Stomatitis / Q000453:epidemiology / Q000209:etiology*; D019172:Transplantation Conditioning / Q000009:adverse effects; D014184:Transplantation, Homologous; D024502:alpha-Tocopherol / Q000097:blood / Q000378:metabolism*; D019207:beta Carotene / Q000097:blood / Q000378:metabolism*
chemical_list: D019207:beta Carotene; D024502:alpha-Tocopherol; D001205:Ascorbic Acid