Ogura Saki, Soga Yoshihiko, Fujiwara Hideaki, Miura Rumi, Matsuoka Ken-Ichi, Maeda Yoshinobu, Kuboki Takuo
Division of Dental Hygienist, Okayama University Hospital, Okayama, Japan.
Division of Hospital Dentistry, Okayama University Hospital, Okayama, Japan.
Support Care Cancer. 2025 Mar 5;33(4):252. doi: 10.1007/s00520-025-09313-z.
This study was performed to examine the effects of conditioning regimens on oral mucositis in haploidentical (haplo) donor hematopoietic stem cell transplantation (HSCT) with posttransplant cyclophosphamide (PTCy).
Thirty consecutive patients (male, 23; female, 7; 18-68 years, median, 59 years) undergoing haplo-HSCT with PTCy using one of three conditioning regimens-reduced intensity conditioning (RIC)-melphalan (Mel); RIC-Busulfan (Bu); and myeloablative conditioning (MAC)-Bu-were enrolled in this study. Data on the WHO grade of oral mucositis (day - 7 to + 20) were collected retrospectively. The incidences of ulcerative and severe mucositis (Grade 2-4 and Grade 3-4, respectively) were compared between the three groups.
Ulcerative mucositis occurred in 0% (0/10) of patients in the RIC-Mel group, 57.1% (4/7) in the RIC-Bu group, and 100% (13/13) in the MAC-Bu group. The differences between the RIC-Mel and RIC-Bu groups and between the RIC-Bu and MAC-Bu groups were significant (all P < 0.05). Severe mucositis occurred in 57.1% (4/7) of patients in the RIC-Bu group and 100% (13/13) of patients in the MAC-Bu group, and the difference was significant (P < 0.05). The rates of ulcerative mucositis (≥ grade 2) and of severe mucositis (≥ grade 3) were significantly higher in the MAC-Bu group than the RIC-Bu group on days 10, 13, 15, and 16 and on days 10, 14, 15, and 16, respectively (all P < 0.05).
The risk of oral mucositis in patients undergoing haplo-HSCT with PTCy is highest with the MAC-Bu conditioning regimen, followed by RIC-Bu, and lowest with RIC-Mel.
本研究旨在探讨预处理方案对单倍体（haplo）供者造血干细胞移植（HSCT）联合移植后环磷酰胺（PTCy）所致口腔黏膜炎的影响。
连续纳入30例接受haplo-HSCT联合PTCy治疗的患者（男性23例，女性7例；年龄18 - 68岁，中位年龄59岁），采用三种预处理方案之一：减低剂量预处理（RIC）-美法仑（Mel）；RIC-白消安（Bu）；清髓性预处理（MAC）-Bu。回顾性收集世界卫生组织（WHO）口腔黏膜炎分级（第 - 7天至 + 20天）的数据。比较三组患者溃疡性和重度黏膜炎（分别为2 - 4级和3 - 4级）的发生率。
RIC-Mel组患者溃疡性黏膜炎发生率为0%（0/10），RIC-Bu组为57.1%（4/7），MAC-Bu组为100%（13/13）。RIC-Mel组与RIC-Bu组之间以及RIC-Bu组与MAC-Bu组之间的差异均有统计学意义（均P < 0.05）。RIC-Bu组重度黏膜炎发生率为57.1%（4/7），MAC-Bu组为100%（13/13），差异有统计学意义（P < 0.05）。MAC-Bu组溃疡性黏膜炎（≥2级）和重度黏膜炎（≥3级）的发生率在第10、13、15和16天以及第10、14、15和16天分别显著高于RIC-Bu组（均P < 0.05）。
接受haplo-HSCT联合PTCy治疗的患者中，MAC-Bu预处理方案导致口腔黏膜炎的风险最高，其次是RIC-Bu，而RIC-Mel方案导致的风险最低。
