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Oral cryotherapy can significantly reduce oral mucositis but not acute GVHD incidence in Flu/Mel conditioning allo-SCT

Bone Marrow Transplantation volume 47, pages 739–741 (2012)Cite this article

Oral cavity cooling (cryotherapy) provided during high-dose melphalan bolus or short-infusion administration contributes to local vasoconstriction, lower blood circulation, lower local cytotoxic drug exposure and significantly reduced oral mucositis (OM) incidence.1, 2, 3 OM is a significant posttransplant complication, and together with gut tissue damage and inflammation, caused by conditioning regimens, contributes to the development and pathogenesis of acute GVHD.4, 5, 6 The incidence of acute GVHD varies between 28 and 45% in the Flu/Mel-reduced intensity conditioning regimen comprising of fludarabine total dose 125–150 mg/m2 and melphalan total dose 140–180 mg/m2.1, 7, 8, 9

We decided to analyze the impact of reduced OM incidence (reduced oral tissue damage) on acute GVHD, and analyzed 142 prospectively observed patients after Flu/Mel (fludarabine 30 mg/m2 i.v. once daily for 4 days, melphalan 140 mg/m2 i.v. one day before transplantation) allo-SCT performed at our institution from January 2005 to December 2010. First 90 patients were not provided with prophylactic oral cryotherapy, as this intervention was implemented into oral cavity care first in January 2009. The cryotherapy with ice lollipops, ice-cold water or crushed ice started 5 min before the melphalan administration, continued during the 15 min of the drug infusion and 15 min afterwards. The patients were instructed to keep the ice or water in their mouth, to gargle it, spit it out or swallow it occasionally.

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  1. Department of Haemato-Oncology, University Hospital in Plzen (Pilsen), Plzen (Pilsen), Czech Republic

    S Vokurka, T Svoboda, A Jungova, M Karas & V Koza

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  1. S Vokurka
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  2. T Svoboda
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  3. A Jungova
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  4. M Karas
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Correspondence to S Vokurka.

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Vokurka, S., Svoboda, T., Jungova, A. et al. Oral cryotherapy can significantly reduce oral mucositis but not acute GVHD incidence in Flu/Mel conditioning allo-SCT. Bone Marrow Transplant 47, 739–741 (2012). https://doi.org/10.1038/bmt.2011.156

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