title: Mucositis after reduced intensity conditioning and allogeneic stem cell transplantation.
abstract: BACKGROUND
  Therapyrelated mucositis is associated with considerable morbidity. This complication following allogeneic stem cell therapy (alloSCT) is less severe after reduced intense conditioning (RIC); however, even here it may be serious.
  
  
  METHODS
  52 patients (male: n = 35 (67%), female: n = 17 (33%)) at a median age of 62 years (35-73 years) underwent alloSCT after RIC. Conditioning was either total body irradiation (TBI)(2Gy)/±fludarabine (n = 33, 63.5%) or chemotherapy based. Graftversushost disease (GvHD) prophylaxis was carried out with cyclosporine A ± mycophenolate mofetil (MMF). 45 patients (87%) received shortcourse methotrexate (MTX). Mucositis was graded according to the Bearman and the World Health Organisation (WHO) scale. A variety of parameters were correlated with mucositis.
  
  
  RESULTS
  The Bearman and WHO scales showed excellent correlation. Mucositis was significantly more severe after chemotherapybased conditioning compared to conditioning with TBI(2Gy)/±fludarabine (p < 0.002) as well as in cases with an increase in creatinine levels above the upper normal value (UNV) on day +1 after SCT (p < 0.05). Furthermore, the severity correlated with time to engraftment of leucocytes (correlation coefficient (cc) = 0.26, p < 0.02) and thrombocytes (cc = 0.38, p < 0.001).
  
  
  CONCLUSIONS
  The conditioning regimen and increased creatinine levels at day +1 were identified as factors predicting the severity of mucositis after RICSCT. Creatinine levels on day +1 after SCT may help identify patients at risk for severe mucositis in the further course of transplantation.
authors: Department of Internal Medicine C - Haematology, Oncology and Stem Cell Transplantation, University Hospital Greifswald, Ernst Moritz Arndt University Greifswald, Germany.
authors: Christoph
authors: C
authors: Busemann
authors: Hanna
authors: H
authors: Wilfert
authors: Thomas
authors: T
authors: Neumann
authors: Thomas
authors: T
authors: Kiefer
authors: Gottfried
authors: G
authors: Dölken
authors: William H
authors: WH
authors: Krüger
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000633:toxicity; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use / Q000633:toxicity; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D007958:Leukocyte Count; D008223:Lymphoma / Q000628:therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000633:toxicity; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology*; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D010976:Platelet Count; D013223:Statistics as Topic; D019172:Transplantation Conditioning / Q000379:methods*; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000633:toxicity; D014916:Whole-Body Irradiation / Q000009:adverse effects
chemical_list: D000964:Antimetabolites, Antineoplastic; D014740:Vidarabine; C024352:fludarabine; D008727:Methotrexate