title: The efficacy of erythropoietin mouthwash in prevention of oral mucositis in patients undergoing autologous hematopoietic SCT: a double-blind, randomized, placebo-controlled trial.
abstract: Oral mucositis (OM) as a complication of high-dose chemotherapy is frequently occurred in hematopoietic stem cell transplantation (HSCT) settings. Erythropoietin (EPO) has anti-inflammatory, antioxidant and wound-healing properties and therefore could have an important role in the prevention of OM. We conducted a double-blind, randomized, placebo-controlled trial to evaluate the EPO mouthwash effect on OM incidence and severity in 80 patients with non-Hodgkin's lymphoma, Hodgkin disease (HD) or multiple myeloma, undergoing autologous hematopoietic stem cell transplantation. Patients received either EPO mouthwash (50 IU/ml, 15 ml four times a day) (n = 40) or placebo (n = 40) from the starting day of high-dose chemotherapy until day +14 after transplantation or until the day of discharge from the hospital, whichever occurred first. OM was evaluated daily for 21 days after transplantation or until resolution of OM according to World Health Organization oral toxicity scale. The incidence of OM (grades 1-4) in the EPO mouthwash group and control group was significantly different (27.5% vs 77.5%, p < 0.001). The mean ± SD of two other parameters of OM including maximum intensity OM score (0.60 ± 1.06 vs 1.67 ± 1.27) and average intensity OM score (0.47 ± 0.80 vs 1.28 ± 0.86) was significantly lower in the intervention group (p < 0.001). Moreover, the mean ± SD duration of OM was also significantly shorter among the EPO mouthwash recipients (1.92 ± 3.42 days vs 5.42 ± 3.86 days, P < 0.001). Also, the duration of neutropenic fever was significantly shorter in the intervention group (2.12 ± 2.42 days vs 3.95 ± 4.01 days, p = 0.016). It is concluded that EPO mouthwash can reduce the incidence and duration of OM. Copyright © 2015 John Wiley & Sons, Ltd.
authors: Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors: Hesamoddin
authors: H
authors: Hosseinjani
authors: Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.|Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.
authors: Molouk
authors: M
authors: Hadjibabaie
authors: Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.|Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.
authors: Kheirollah
authors: K
authors: Gholami
authors: Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.|Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mohammadreza
authors: M
authors: Javadi
authors: Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mania
authors: M
authors: Radfar
authors: Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors: Zahra
authors: Z
authors: Jahangard-Rafsanjani
authors: Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors: Emadoddin
authors: E
authors: Hosseinjani
authors: Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors: Nazanin
authors: N
authors: Shabani
authors: Hematology-Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mohammad
authors: M
authors: Vaezi
authors: Hematology-Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Ardeshir
authors: A
authors: Ghavamzadeh
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006689:Hodgkin Disease / Q000150:complications / Q000628:therapy*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes; D009101:Multiple Myeloma / Q000150:complications / Q000628:therapy*; D013280:Stomatitis / Q000517:prevention & control*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D009067:Mouthwashes; D004921:Erythropoietin
keywords: EPO mouthwash; hematopoietic SCT; high-dose chemotherapy; oral mucositis