IADR Abstract Archives
Oral mucositis in patients receiving tacrolimus/sirolimus as GVHD prophylaxis
Objectives: Graft-versus-host disease (GVHD) remains a frequent and serious complication, affecting 30-70% of allogeneic hematopoietic stem cell transplantation (HSCT) recipients. A new regimen in prevention of GVHD is the combination of sirolimus and tacrolimus (Tac/Sir). Sirolimus is a mTOR inhibitor and wound healing complications have been reported.
The hypothesis to be tested in this study was that oral mucositis is more severe in patients treated with (Tac/Sir) compared to standard treatment with cyclosporine in combination with methotrexate (CsA/Mtx).
Methods: A total of 141 patients age range (1-71 years) were included in the study, 73 treated with Tac/Sir and 68 treated with CsA/Mtx. Acute leukemia was the most common diagnosis. 32 patients received myeloablative conditioning (MAC) and 109 reduced intensity conditioning. All patients followed an oral care program including toothbrushing, interdental cleaning and use of ice chips and isotonic saline. From day -3 to day +25 after HSCT oral mucositis (OM) was scored according to WHO scale.
Results: Results showed that the peak WHO OM score was 1.5 (1.3-1.7) in the Tac/Sir group and 1.7 (1.5-1.9) (n.s.) in the CsA/Mtx group and occurred at day +10. There was no statistically significant difference between the two groups from day -3 to +25, except for day +14 when the OM score was significantly lower in Tac/Sir treated patients. Patients diagnosed with OM score 2-4 (n=87) were significantly more often female (p=0.013), had acute leukemia (p=0.022) and received MAC (p<0.001).
Conclusions: In conclusion, the results show that there was no significant difference in oral mucositis score, neither peak or duration between the two immunosuppressive regimens sirolimus and tacrolimus or cyclosporine in combination with methotrexate given to patients receiving allogeneic hematopoietic stem cell transplantation.
The hypothesis to be tested in this study was that oral mucositis is more severe in patients treated with (Tac/Sir) compared to standard treatment with cyclosporine in combination with methotrexate (CsA/Mtx).
Methods: A total of 141 patients age range (1-71 years) were included in the study, 73 treated with Tac/Sir and 68 treated with CsA/Mtx. Acute leukemia was the most common diagnosis. 32 patients received myeloablative conditioning (MAC) and 109 reduced intensity conditioning. All patients followed an oral care program including toothbrushing, interdental cleaning and use of ice chips and isotonic saline. From day -3 to day +25 after HSCT oral mucositis (OM) was scored according to WHO scale.
Results: Results showed that the peak WHO OM score was 1.5 (1.3-1.7) in the Tac/Sir group and 1.7 (1.5-1.9) (n.s.) in the CsA/Mtx group and occurred at day +10. There was no statistically significant difference between the two groups from day -3 to +25, except for day +14 when the OM score was significantly lower in Tac/Sir treated patients. Patients diagnosed with OM score 2-4 (n=87) were significantly more often female (p=0.013), had acute leukemia (p=0.022) and received MAC (p<0.001).
Conclusions: In conclusion, the results show that there was no significant difference in oral mucositis score, neither peak or duration between the two immunosuppressive regimens sirolimus and tacrolimus or cyclosporine in combination with methotrexate given to patients receiving allogeneic hematopoietic stem cell transplantation.