López-Espinoza Tomas, Sacomori Cinara, Gutiérrez-Silva Lizette, Peña-Espinoza Mónica, Roldán Paola, Araya-Castro Paulina
Servicio de Medicina Física y Rehabilitación, Clínica Dávila, Santiago, Chile.
Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Avenida Plaza 680, Las Condes, Santiago, Chile.
Support Care Cancer. 2025 Jun 27;33(7):634. doi: 10.1007/s00520-025-09702-4.
Hematopoietic cell transplantation (HCT) is a curative treatment for hematological malignancies that aims to restore hematopoietic function. However, it involves significant toxicities, including oral mucositis. Oral mucositis (OM) impairs nutrition, extends hospital stays, and reduces quality of life. Physical function declines post-transplant, but the role of severe oral mucositis in worsening this impairment remains unclear. To compare the differences in physical function and treatment-related symptoms before and after HCT between adult patients with hematologic cancer who did and did not develop severe oral mucositis during their hospitalization. A prospective longitudinal study was conducted at Clínica Dávila, Santiago, Chile, with 31 adult patients undergoing allogeneic or autologous HCT between September 2023 and March 2024. Patients were grouped based on the presence of severe OM, which was assessed using the WHO scale. Physical function was evaluated with the 30-second sit-to-stand test, handgrip strength, and the 2-minute step test, while treatment-related symptoms intensity was measured using the Edmonton Symptom Assessment Scale. OM incidence was 74.2%, with severe OM affecting 29% of patients. Patients with severe OM scored significantly lower on the sit-to-stand test (Mean Difference 1.5 repetitions, p=0.048); showed higher levels of pain, appetite loss, and nausea; and required more days of parenteral nutrition (p<0.05). OM onset occurred at day 9.3 post-allogeneic HCT and day 13.6 post-autologous HCT, ending at day 17.0 and day 11.3, respectively. Patients who develop severe oral mucositis after undergoing HCT experience greater impairment in lower limb strength, loss of appetite, pain and nausea at discharge than their counterparts.
造血细胞移植（HCT）是一种用于治疗血液系统恶性肿瘤的根治性疗法，旨在恢复造血功能。然而，它会带来显著的毒性，包括口腔黏膜炎。口腔黏膜炎（OM）会影响营养状况、延长住院时间并降低生活质量。移植后身体功能会下降，但严重口腔黏膜炎在加剧这种损害方面的作用仍不清楚。为了比较住院期间发生和未发生严重口腔黏膜炎的成年血液系统癌症患者在HCT前后身体功能和治疗相关症状的差异。在智利圣地亚哥的达维拉诊所进行了一项前瞻性纵向研究，有31名成年患者在2023年9月至2024年3月期间接受了异基因或自体HCT。根据严重OM的存在情况对患者进行分组，使用世界卫生组织量表进行评估。通过30秒坐立试验、握力和2分钟步行试验评估身体功能，同时使用埃德蒙顿症状评估量表测量治疗相关症状的强度。OM发生率为74.2%，严重OM影响29%的患者。发生严重OM的患者在坐立试验中的得分显著更低（平均差异1.5次重复，p = 0.048）；表现出更高水平的疼痛、食欲减退和恶心；并且需要更多天的肠外营养（p < 0.05）。OM在异基因HCT后第9.3天和自体HCT后第13.6天开始，分别在第17.0天和第11.3天结束。接受HCT后发生严重口腔黏膜炎的患者在出院时下肢力量、食欲丧失、疼痛和恶心方面的损害比未发生严重口腔黏膜炎的患者更大。
