Palifermin Compared to Supersaturated Calcium Phosphate Rinse in Prevention of Severe Oral Mucositis after Stem Cell Transplantation in Patients Receiving Radiotherapy-Based Myeloablative Conditioning
Purpose: Oral mucositis (OM) is a common, debilitating complication of conditioning regimens for hematopoietic stem cell transplantation (HSCT). Supersaturated calcium phosphate rinse (SCPR) and palifermin have shown efficacy in preventing severe OM. However, whether their efficacy differs is unknow...
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MDPI AG
2023-02-01
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| Series: | Hemato |
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| Online Access: | https://www.mdpi.com/2673-6357/4/1/6 |
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| author | Tarik Hadid Ayad Al-Katib Jose Binongo Gina M. Berteotti Salman Fazal James M. Rossetti John Lister |
| author_facet | Tarik Hadid Ayad Al-Katib Jose Binongo Gina M. Berteotti Salman Fazal James M. Rossetti John Lister |
| author_sort | Tarik Hadid |
| collection | DOAJ |
| description | Purpose: Oral mucositis (OM) is a common, debilitating complication of conditioning regimens for hematopoietic stem cell transplantation (HSCT). Supersaturated calcium phosphate rinse (SCPR) and palifermin have shown efficacy in preventing severe OM. However, whether their efficacy differs is unknown. We aimed to compare the efficacy of SCPR and palifermin in HSCT patients receiving myeloablative conditioning. Methods: A comprehensive review of our institutional database was performed to identify patients who received myeloablative-conditioning therapy over 5 years. All HSCT patients who received radiotherapy-based myeloablative conditioning and received either palifermin or SCPR within the study period were included. Most patients received Fludarabine, Busulfan, and total body irradiation (FBT). Patients were divided into two groups based on the OM prophylactic agent received. The primary outcome is prevalence of severe OM (WHO Grade 3 and 4). The secondary outcomes are a prevalence of all-grade OM and WHO Grade 4 OM. These outcomes were compared between the two groups. Results: We identified 26 patients who received SCPR and 122 patients who received palifermin for OM prophylaxis. The prevalence of World Health Organization (WHO) Grade 3 or 4 OM was significantly lower in the palifermin group (57% vs. 100%, <i>p</i> = 0.01). In addition, the palifermin group had lower WHO Grade 4 OM (22% vs. 62%, <i>p</i> = 0.0006). The overall prevalence of OM was not significantly different between the two groups (86% for palifermin group vs. 100% for SCPR arm, <i>p</i> = 0.15). Subgroup analyses demonstrated improved outcomes with palifermin, regardless of age, sex, disease status, donor type, and primary diagnosis. Conclusion: When compared to SCPR, the use of palifermin is associated reduced severity of OM in HSCT patients receiving radiotherapy-based myeloablative conditioning. |
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| format | Article |
| id | doaj.art-8306434e4f0d4f389b741fd612f6b601 |
| institution | Directory Open Access Journal |
| issn | 2673-6357 |
| language | English |
| last_indexed | 2024-03-11T06:29:12Z |
| publishDate | 2023-02-01 |
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| series | Hemato |
| spelling | doaj.art-8306434e4f0d4f389b741fd612f6b6012023-11-17T11:22:22ZengMDPI AGHemato2673-63572023-02-0141586710.3390/hemato4010006Palifermin Compared to Supersaturated Calcium Phosphate Rinse in Prevention of Severe Oral Mucositis after Stem Cell Transplantation in Patients Receiving Radiotherapy-Based Myeloablative ConditioningTarik Hadid0Ayad Al-Katib1Jose Binongo2Gina M. Berteotti3Salman Fazal4James M. Rossetti5John Lister6Department of Oncology, School of Medicine, Wayne State University, Detroit, MI 48201, USADepartment of Oncology, School of Medicine, Wayne State University, Detroit, MI 48201, USARollins School of Public Health, Emory University, Atlanta, GA 30322, USADivision of Hematology and Cellular Therapy, The Western Pennsylvania Hospital, Pittsburgh, PA 15212, USADivision of Hematology and Cellular Therapy, The Western Pennsylvania Hospital, Pittsburgh, PA 15212, USAUPMC Hillman Cancer Center, Pittsburgh, PA 15232, USADivision of Hematology and Cellular Therapy, The Western Pennsylvania Hospital, Pittsburgh, PA 15212, USAPurpose: Oral mucositis (OM) is a common, debilitating complication of conditioning regimens for hematopoietic stem cell transplantation (HSCT). Supersaturated calcium phosphate rinse (SCPR) and palifermin have shown efficacy in preventing severe OM. However, whether their efficacy differs is unknown. We aimed to compare the efficacy of SCPR and palifermin in HSCT patients receiving myeloablative conditioning. Methods: A comprehensive review of our institutional database was performed to identify patients who received myeloablative-conditioning therapy over 5 years. All HSCT patients who received radiotherapy-based myeloablative conditioning and received either palifermin or SCPR within the study period were included. Most patients received Fludarabine, Busulfan, and total body irradiation (FBT). Patients were divided into two groups based on the OM prophylactic agent received. The primary outcome is prevalence of severe OM (WHO Grade 3 and 4). The secondary outcomes are a prevalence of all-grade OM and WHO Grade 4 OM. These outcomes were compared between the two groups. Results: We identified 26 patients who received SCPR and 122 patients who received palifermin for OM prophylaxis. The prevalence of World Health Organization (WHO) Grade 3 or 4 OM was significantly lower in the palifermin group (57% vs. 100%, <i>p</i> = 0.01). In addition, the palifermin group had lower WHO Grade 4 OM (22% vs. 62%, <i>p</i> = 0.0006). The overall prevalence of OM was not significantly different between the two groups (86% for palifermin group vs. 100% for SCPR arm, <i>p</i> = 0.15). Subgroup analyses demonstrated improved outcomes with palifermin, regardless of age, sex, disease status, donor type, and primary diagnosis. Conclusion: When compared to SCPR, the use of palifermin is associated reduced severity of OM in HSCT patients receiving radiotherapy-based myeloablative conditioning.https://www.mdpi.com/2673-6357/4/1/6paliferminsupersaturated calcium phosphate rinsemucositismyeloablativehematopoietic stem cell transplantation |
| spellingShingle | Tarik Hadid Ayad Al-Katib Jose Binongo Gina M. Berteotti Salman Fazal James M. Rossetti John Lister Palifermin Compared to Supersaturated Calcium Phosphate Rinse in Prevention of Severe Oral Mucositis after Stem Cell Transplantation in Patients Receiving Radiotherapy-Based Myeloablative Conditioning Hemato palifermin supersaturated calcium phosphate rinse mucositis myeloablative hematopoietic stem cell transplantation |
| title | Palifermin Compared to Supersaturated Calcium Phosphate Rinse in Prevention of Severe Oral Mucositis after Stem Cell Transplantation in Patients Receiving Radiotherapy-Based Myeloablative Conditioning |
| title_full | Palifermin Compared to Supersaturated Calcium Phosphate Rinse in Prevention of Severe Oral Mucositis after Stem Cell Transplantation in Patients Receiving Radiotherapy-Based Myeloablative Conditioning |
| title_fullStr | Palifermin Compared to Supersaturated Calcium Phosphate Rinse in Prevention of Severe Oral Mucositis after Stem Cell Transplantation in Patients Receiving Radiotherapy-Based Myeloablative Conditioning |
| title_full_unstemmed | Palifermin Compared to Supersaturated Calcium Phosphate Rinse in Prevention of Severe Oral Mucositis after Stem Cell Transplantation in Patients Receiving Radiotherapy-Based Myeloablative Conditioning |
| title_short | Palifermin Compared to Supersaturated Calcium Phosphate Rinse in Prevention of Severe Oral Mucositis after Stem Cell Transplantation in Patients Receiving Radiotherapy-Based Myeloablative Conditioning |
| title_sort | palifermin compared to supersaturated calcium phosphate rinse in prevention of severe oral mucositis after stem cell transplantation in patients receiving radiotherapy based myeloablative conditioning |
| topic | palifermin supersaturated calcium phosphate rinse mucositis myeloablative hematopoietic stem cell transplantation |
| url | https://www.mdpi.com/2673-6357/4/1/6 |
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