¹Fred Hutchinson Cancer Research Center, the Seattle Cancer Care Alliance and the University of Washington, Seattle, WA, USA

Correspondence: Dr W Bensinger, Clinical Research, Fred Hutchinson Cancer Research Center, the Seattle Cancer Care Alliance and the University of Washington, 1100 Fairview Ave N., D5-390, Seattle, WA 98109-1024, USA. E-mail: wbensing@fhcrc.org

Received 2 February 2006; Revised 21 March 2006; Accepted 22 March 2006; Published online 24 April 2006.

Abstract

Forty patients with multiple myeloma scheduled to receive melphalan 200 mg/m² followed by autologous stem cell transplantation were randomly assigned to receive oral cryotherapy or room temperature normal saline rinses 30 min before and for 6 h after high-dose therapy. Patients were evaluated for the development of mucositis using the National Cancer Institute grading system as well as evaluation of secondary measures such as days of total parenteral nutrition (TPN), narcotic use, hospitalization, weight loss and resumption of oral caloric intake for 28 days after transplant. Patients self-scored their pain, swallowing, drinking, eating, sleeping and taste alterations for 28 days. The primary end point of this trial was the incidence of grades 3–4 mucositis. Compared to the normal saline group, patients using cryotherapy experienced less grade 3–4 mucositis, 14 vs 74%, P=0.0005. Patients receiving cryotherapy also had statistically lower uses of narcotics and TPN, although there were no differences in length of hospitalization or weight loss. Patient-reported pain was significantly lower and activities were significantly better in the cryotherapy group.