The prevention of oral mucositis in patients with blood cancers: current concepts and emerging landscapes.
BACKGROUND
The prevention of oral mucositis (OM) in the management of hematological malignancies continues to represent an unmet clinical need. Addressing this issue has major clinical implications as OM can also greatly impair patient's quality of life.


OBJECTIVE
To review currently available measures and investigational agents to prevent OM in hematological patients.


METHODS
we searched for OM and related issues using Medline; the abstract books of the most important hematological and oncological meetings were also reviewed.


CONCLUSIONS
Many agents targeting different mechanisms of mucosal damage have been applied in order to prevent OM; most of them have failed or its efficacy has not been fully demonstrated. Palifermin is the first pharmaceutical/biological agent approved for the prevention of OM; its use is currently restricted to patients who have received radiotherapy-containing conditioning regimens prior to autologous hematopoietic stem cell transplantation. No clear benefit by this agent has been demonstrated outside of this specific setting and its application should be limited to clinical trials. Other interventions, such as other growth factors and non mitogenic measures are under investigation or in development and their application in the hematological setting is expected in the short term.
Hematology Division, S. Eugenio Hospital, Rome, Italy. pniscola@gmail.com
Pasquale
P
Niscola
Andrea
A
Tendas
Luca
L
Cupelli
Gianfranco
G
Catalano
Laura
L
Scaramucci
Marco
M
Giovannini
Vito
V
Trinchieri
Atul
A
Sharma
Fabio
F
Efficace
Claudio
C
Cartoni
Daniela
D
Piccioni
Alessio
A
Perrotti
Teresa
T
Dentamaro
Paolo
P
de Fabritiis
Dorothy M K
DM
Keefe
D051523:Fibroblast Growth Factor 7 / Q000627:therapeutic use*; D019337:Hematologic Neoplasms / Q000150:complications* / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D009061:Mouth Mucosa / Q000187:drug effects*; D013280:Stomatitis / Q000150:complications* / Q000188:drug therapy / Q000517:prevention & control*; D019172:Transplantation Conditioning / Q000009:adverse effects
D051523:Fibroblast Growth Factor 7