Department of Clinical Hematology, Armed Forces Bone Marrow Transplant Center, Rawalpindi, Pakistan.
J Coll Physicians Surg Pak. 2023 Jul;33(7):804-808. doi: 10.29271/jcpsp.2023.07.804.
To determine the factors affecting the frequency and severity of oral mucositis are following hematopoietic stem cell transplantation.
Descriptive study. Place and Duration of the Study: Armed Forces Bone Marrow Transplant Centre Rawalpindi, from September 2020 to February 2022.
Patients who underwent allogenic stem cell transplantation were enrolled. Patients were analysed based on history and examination for oral mucositis (OM) as per the WHO mucositis scale, from the start of conditioning chemotherapy till discharge, total duration of mucositis and type of medication were noted. Its association with risk factors like age, gender, conditioning chemotherapy, methotrexate (MTX) for GVHD prophylaxis, and prior history of irradiation was determined.
Mean age of the 72 transplant recipients was 21.9 ± 14 years, with 48 males and 24 females. The common underlying diseases were beta-thalassemia major (30.6%, n=22), acute lymphoblastic leukaemia (n=15, 20.8%), aplastic anaemia (n=10, 13.9%), and multiple myeloma (n=8, 11.1%). The frequency of mucositis in those aged under 15 years was 79.3% (n=23) and in those older than 15 years was 74.4% (n=32). Frequency of mucositis was statistically significant in patients who received myeloablative conditioning regimen (85% vs. 20%, p <0.01), and who had prophylactic. MTX (91% vs. 48%, p<0.01) and who had prior craniospinal (CSI) radiation (100% vs. 70.2%, p=0.01). There was no statistical significance between stem cell dose (CD34/TNC) and mucositis. Severity of mucositis was significantly greater in Allogenic vs. auto HSCT (p=0.04). All the patients with mucositis required analgesics for pain management.
Oral mucositis is a common but potentially debilitating complication of stem cell transplant, requiring opioid analgesia in a significant number of cases. Myeloablative conditioning, prophylactic MTX, and prior CSI are significantly associated with mucositis in transplant patients.
Hematopoietic stem cell transplantation (HSCT), Oral Mucositis, Myeloablative conditioning, Methotrexate, Analgesia.
确定影响造血干细胞移植后口腔黏膜炎发生频率和严重程度的因素。
描述性研究。研究地点和时间：武装部队骨髓移植中心，拉瓦尔品第，2020 年 9 月至 2022 年 2 月。
入组接受异基因干细胞移植的患者。根据 WHO 口腔黏膜炎量表，从开始进行预处理化疗到出院，对每位患者进行口腔黏膜炎（OM）的病史和检查，记录口腔黏膜炎的总持续时间和用药类型。分析其与年龄、性别、预处理化疗、预防移植物抗宿主病（GVHD）的甲氨蝶呤（MTX）、以及既往放疗等危险因素的关系。
72 例移植受者的平均年龄为 21.9 ± 14 岁，其中男性 48 例，女性 24 例。常见的基础疾病为β-地中海贫血（30.6%，n=22）、急性淋巴细胞白血病（n=15，20.8%）、再生障碍性贫血（n=10，13.9%）和多发性骨髓瘤（n=8，11.1%）。年龄在 15 岁以下的患者口腔黏膜炎发生率为 79.3%（n=23），年龄在 15 岁以上的患者发生率为 74.4%（n=32）。接受清髓性预处理方案的患者口腔黏膜炎发生率有统计学意义（85% vs. 20%，p<0.01），预防性使用 MTX（91% vs. 48%，p<0.01）和既往颅脊髓照射（CSI）（100% vs. 70.2%，p=0.01）。干细胞剂量（CD34/TNC）与口腔黏膜炎之间无统计学意义。异基因与自体 HSCT 相比，口腔黏膜炎的严重程度更大（p=0.04）。所有发生口腔黏膜炎的患者均需要使用镇痛药进行疼痛管理。
口腔黏膜炎是干细胞移植的一种常见但潜在致残性并发症，在许多情况下需要使用阿片类镇痛药。清髓性预处理、预防性 MTX 和既往 CSI 与移植患者的口腔黏膜炎显著相关。
造血干细胞移植（HSCT）、口腔黏膜炎、清髓性预处理、甲氨蝶呤、镇痛。
