1. ¹Department of Oral Medicine, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
2. ²Department of Bone Marrow Transplantation, Hadassah University Medical Center, Jerusalem, Israel

Correspondence: Dr S Elad, Department of Oral Medicine, Hebrew University-Hadassah School of Dental Medicine, POB 12272, Jerusalem 91120, Israel. E-mail: eladhome@md.huji.ac.il

Received 25 October 2005; Revised 13 January 2006; Accepted 19 January 2006; Published online 6 March 2006.

Abstract

The aim of this study was to evaluate the safety, tolerability and efficacy of a topical gel containing histamine dihydrochloride (HDC) versus a placebo gel in preventing oral mucositis in hematopoietic stem cell transplantation (HSCT) patients. A total of 45 patients post-HSCT were enrolled in a prospective longitudinal, placebo-controlled, double-blind study. Patients were evaluated twice weekly for oral mucositis (OMAS, NCI score), oral pain (VAS), oral function and salivary flow rate. Compliance was assessed using a patient diary. Oral mucositis developed in 85% of the HDC group and 63% of the placebo group. The mean maximal intensity for NCI score was 1.451 in the HDC group and 1.211.27 in the placebo group (P=0.37). The mean duration of oral mucositis was 4.73.6 and 2.332.23 days in the HDC and placebo groups, respectively (P=0.06). The same trends were measured with OMAS. Visual analogue scale for oral pain and oral function was not significantly different between the two groups. Histamine dihydrochloride was found to be safe. In the search for topical agents for the prevention of mucositis, we found that HDC neither improves nor worsens oral mucositis in HSCT patients. The balance between the pro- and anti-inflammatory effects of HDC should be investigated further in order to acquire a clinically effective topical medication based on its anti-inflammatory properties.