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Graft-Versus-Host Disease

Etoposide induces more severe mucositis than CY when added to TBI as conditioning in allograft recipients receiving CsA and MTX

Bone Marrow Transplantation volume 45, pages 1457–1462 (2010)Cite this article

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Abstract

Fractionated TBI and etoposide (FTBI–VP16) conditioning is effective therapy for patients receiving allogeneic stem cell transplants for ALL. One of the major dose-limiting toxicities with this regimen is mucositis although its effect on patients and hospital resources is not well described. To determine the severity of mucositis (WHO grade 3–4) experienced and assess resource utilisation, we compared the non-haematological toxicities of 38 patients receiving FTBI–VP16 with 104 patients receiving CY and TBI (CYTBI). FTBI–VP16 patients were more likely to develop severe mucositis (odds ratio (OR) 6.0 (95% confidence interval (CI) 1.36, 54.42), P<0.01) and its duration was longer (11.5 vs 8 days, P<0.01). Resource utilisation was considerably higher especially in the use and duration of i.v. narcotics and parenteral nutrition, nursing care requirements and plt-transfusion support. Patients receiving FTBI–VP16 conditioning are ideal candidates for new therapies to prevent or reduce the severity of mucositis.

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Acknowledgements

Amgen Australia Pty Ltd provided financial assistance for this project.

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Authors and Affiliations

  1. Department of Clinical Haematology & BMT Service, The Royal Melbourne Hospital, Victoria, Australia

    R Hoyt, D S Ritchie, J Szer & A P Grigg

  2. Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria, Australia

    A Wirth

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  1. R Hoyt
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  2. D S Ritchie
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  3. A Wirth
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  4. J Szer
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  5. A P Grigg
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Correspondence to A P Grigg.

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Hoyt, R., Ritchie, D., Wirth, A. et al. Etoposide induces more severe mucositis than CY when added to TBI as conditioning in allograft recipients receiving CsA and MTX. Bone Marrow Transplant 45, 1457–1462 (2010). https://doi.org/10.1038/bmt.2009.365

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