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Post-Transplant Events

The Prospective Oral Mucositis Audit: relationship of severe oral mucositis with clinical and medical resource use outcomes in patients receiving high-dose melphalan or BEAM-conditioning chemotherapy and autologous SCT

Bone Marrow Transplantation volume 43, pages 141–147 (2009)Cite this article

Abstract

The Prospective Oral Mucositis Audit was an observational study in 197 patients with multiple myeloma (MM) or non-Hodgkin's lymphoma (NHL) undergoing, respectively, high-dose melphalan or BEAM chemotherapy and autologous SCT at 25 European centres. We evaluated the relationship between severe oral mucositis (SOM; WHO Oral Toxicity Scale grade 3–4) and local and systemic clinical sequelae and medical resource use. SOM occurred in 44% of patients. The duration of SOM (mean 5.3 days) correlated with time to neutrophil engraftment. The following parameters increased gradiently with maximum grade of oral mucositis: duration of pain score ⩾4, opioid use, dysphagia score ⩾4, total parenteral nutrition (TPN) use, incidence and/or duration of fever and infection, and duration of antibiotic use. SOM increased the duration of TPN use by 2.7 days (P<0.001), opioids by 4.6 days (P<0.001), and antibiotics by 2.4 days (P=0.045). SOM prolonged hospital stay by 2.3 days (P=0.013) in MM patients, but not in NHL patients (who tended to have a longer hospital stay). In conclusion, this analysis of prospectively collected observational data provides important insight into the scope and impact of SOM in the European transplant setting.

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Acknowledgements

Roisin Cinnéide and Kim Champion were data manager and study coordinator, respectively. The EBMT Oral Mucositis Advisory Group wishes to thank Amgen (Europe) GmbH, Zug, Switzerland, for supporting this work. Julia Balfour (Consultant Medical Writer, Kilconquhar, Scotland) and Claire Foster (Amgen (Europe) GmbH) assisted with the writing of the paper. We also gratefully acknowledge the participation of the investigators, staff and patients from the study centres.

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Authors and Affiliations

  1. Department of Haematology, St James's Hospital, Dublin, Ireland

    S McCann

  2. II Department of Internal Medicine, European Center of Pharmaceutical Medicine, Hematology/Oncology, University of Basel, Basel, Switzerland

    M Schwenkglenks

  3. Amgen (Europe) GmbH, Zug, Switzerland

    P Bacon

  4. Department of Internal Medicine II, Julius Maximilian's University of Würzburg, Würzburg, Germany

    H Einsele

  5. Institute of Haematology and Medical Oncology ‘L. and A. Seragnoli’, Bologna, Italy

    A D'Addio

  6. Department of Haematology, Universitaire Ziekenhuizen Leuven, Catholic University, Leuven, Belgium

    J Maertens

  7. Department of Haematology and Oncology, University of Leipzig, Leipzig, Germany

    D Niederwieser

  8. BMT Unit, Medical University of Vienna, Vienna, Austria

    W Rabitsch

  9. Karolinska Institutet, Institute of Odontology, Huddinge, Sweden

    A Roosaar

  10. Helsinki University Central Hospital, Helsinki, Finland

    T Ruutu

  11. University Hospital Maastricht, Maastricht, The Netherlands

    H Schouten

  12. Nottingham City Hospital NHS Trust, Nottingham, UK

    R Stone

  13. University Hospital Alej Svobody 80, Plzen, Czech Republic

    S Vorkurka

  14. St George's Hospital, London, UK

    B Quinn

  15. Department of Haematology, University Medical Centre St Radboud, Nijmegen, The Netherlands

    N Blijlevens

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McCann, S., Schwenkglenks, M., Bacon, P. et al. The Prospective Oral Mucositis Audit: relationship of severe oral mucositis with clinical and medical resource use outcomes in patients receiving high-dose melphalan or BEAM-conditioning chemotherapy and autologous SCT. Bone Marrow Transplant 43, 141–147 (2009). https://doi.org/10.1038/bmt.2008.299

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