Guo Jingjing, Zhang Hongyong, Lu Xuan, Xia Linghui
Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China.
Support Care Cancer. 2023 Apr 19;31(5):282. doi: 10.1007/s00520-023-07755-x.
Mucositis is a frequent and severe complication in haematopoietic stem cell transplantation (HSCT). The effectiveness of probiotics in mucositis has been indicated by several clinical trials, but the results are still controversial. To date, studies on the influence of probiotics in HSCT are limited. Therefore, we conducted this retrospective study to evaluate the impact of viable Bifidobacterium tablets on the incidence and duration of chemotherapy-/radiation-induced mucositis in patients undergoing HSCT.
Clinical data of 278 patients who underwent HSCT between May 2020 and November 2021 were retrospectively analysed. They were divided into a control group (138) and a probiotic group (140) according to whether they took viable Bifidobacterium tablets. First, we analysed the baseline data of the two groups. Then, we compared the incidence, severity and duration of mucositis between the two groups by using Mann-Whitney U test, chi-square test and Fisher's exact test according to the type of data. In order to exclude the influence of confounding factors, we further evaluated the efficacy of oral probiotics in preventing oral mucositis by Binary logistic regression analysis.
The use of viable Bifidobacterium tablets markedly reduced the incidence of oral mucositis (OM) (62.9% vs. 81.2%, p = 0.001) and mainly reduced the incidence of grades 1-2 OM (74.6% vs. 58.6%, p = 0.005). There was no significant difference in the incidence of severe (grades 3-4) OM between the two groups (6.5% vs. 4.3%, p = 0.409). The median duration of OM was shorter in the probiotic group (10 vs. 12 days, p = 0.037). The incidence and duration of diarrhoea did not differ between the two groups. Moreover, the use of viable Bifidobacterium tablets had no influence on engraftment.
Our results suggested that viable Bifidobacterium tablets could effectively reduce the incidence of grades 1-2 OM and duration of OM during the transplant process without affecting the outcome of HSCT.
黏膜炎是造血干细胞移植(HSCT)中常见且严重的并发症。多项临床试验表明益生菌对黏膜炎有疗效,但结果仍存在争议。迄今为止,关于益生菌在HSCT中的影响的研究有限。因此,我们开展了这项回顾性研究,以评估活性双歧杆菌片对接受HSCT患者化疗/放疗引起的黏膜炎的发生率和持续时间的影响。
回顾性分析2020年5月至2021年11月期间接受HSCT的278例患者的临床资料。根据是否服用活性双歧杆菌片,将他们分为对照组(138例)和益生菌组(140例)。首先,我们分析了两组的基线数据。然后,根据数据类型,使用曼-惠特尼U检验、卡方检验和费舍尔精确检验比较两组之间黏膜炎的发生率、严重程度和持续时间。为了排除混杂因素的影响,我们通过二元逻辑回归分析进一步评估口服益生菌预防口腔黏膜炎的疗效。
服用活性双歧杆菌片显著降低了口腔黏膜炎(OM)的发生率(62.9%对81.2%,p = 0.001),主要降低了1-2级OM的发生率(74.6%对58.6%,p = 0.005)。两组之间重度(3-4级)OM的发生率无显著差异(6.5%对4.3%,p = 0.409)。益生菌组OM的中位持续时间较短(10天对12天,p = 0.037)。两组之间腹泻的发生率和持续时间没有差异。此外,服用活性双歧杆菌片对植入没有影响。
我们的结果表明,活性双歧杆菌片可以有效降低移植过程中1-2级OM的发生率和OM的持续时间,而不影响HSCT的结果。