title: Palifermin for prevention of oral mucositis in allogeneic hematopoietic stem cell transplantation: a single-institution retrospective evaluation.
abstract: OBJECTIVE
  The purpose of this study is to assess the impact of palifermin on oral mucositis (OM) and its sequelae in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) who were conditioned with fractionated total body irradiation (FTBI) and etoposide.
  
  
  METHODS
  This retrospective chart review study compared the effect of palifermin on the development of OM in patients who received this agent during an allo-HSCT (n = 99) to those who did not (n = 30). The primary end points were severity and duration of OM. Secondary end points included requirements for opioids, total parenteral nutrition (TPN), and intensive oral care; incidence of infection; length of hospital stay; and overall survival.
  
  
  RESULTS
  There was no significant difference in the incidence of all grades of OM, but incidence of severe OM was decreased in palifermin-exposed patients (34 vs 80 %, p < 0.0001). In patients who developed OM (all grades), the median duration of OM was shorter in palifermin-exposed patients (13 vs 18 days, p = 0.0001); there was no difference in the median duration of severe OM. Patients who received palifermin used less opioids and required a shorter duration of intensive oral care. There was no difference in duration of TPN, incidence of infection, length of hospital stay, and overall survival.
  
  
  CONCLUSIONS
  Our findings demonstrated a significant benefit with the use of palifermin for allo-HSCT recipients who were conditioned with FTBI and etoposide. Palifermin can potentially improve quality of life for this patient population and reduce complications and resources used during the transplant process. A randomized clinical trial is required to confirm these results.
authors: Department of Pharmacy, City of Hope National Medical Center, Duarte, CA, USA. dtn044@ucsd.edu.
authors: Diana T
authors: DT
authors: Nguyen
authors: Department of Pharmacy, City of Hope National Medical Center, Duarte, CA, USA.
authors: Sepideh
authors: S
authors: Shayani
authors: Department of Biostatistics, City of Hope National Medical Center, Duarte, CA, USA.
authors: Joycelynne
authors: J
authors: Palmer
authors: Department of Biostatistics, City of Hope National Medical Center, Duarte, CA, USA.
authors: Andrew
authors: A
authors: Dagis
authors: Division of Hematology/HSCT, City of Hope National Medical Center, Duarte, CA, USA.
authors: Stephen J
authors: SJ
authors: Forman
authors: Department of Head and Neck Surgery, City of Hope National Medical Center, Duarte, CA, USA.
authors: Joel
authors: J
authors: Epstein
authors: Division of Hematology/HSCT, City of Hope National Medical Center, Duarte, CA, USA.
authors: Ricardo
authors: R
authors: Spielberger
mesh_terms: D000293:Adolescent; D000328:Adult; D005047:Etoposide / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D051523:Fibroblast Growth Factor 7 / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D011788:Quality of Life; D012189:Retrospective Studies; D013280:Stomatitis / Q000209:etiology / Q000517:prevention & control*; D014916:Whole-Body Irradiation / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D051523:Fibroblast Growth Factor 7; D005047:Etoposide
keywords: Allogeneic stem cell transplant; Fractionated total body irradiation; Mucositis; Palifermin; Retrospective