Dataset Information

Prevalence and risk factors of oral mucositis in paediatric patients undergoing haematopoietic stem cell transplantation.

ABSTRACT:

Background

A complete understanding of oral mucositis (OM) is crucial to develop appropriate interventions to aid in the successful overall health outcome of paediatric patients undergoing haematopoietic stem cell transplantation (HSCT).

Aims

This study aimed at determining the prevalence and severity of OM and at identifying the predictive factors that might aggravate OM at one-week, two-week and three-week post-HSCT.

Methods

This retrospective, hospital-based study reviewed the medical records of 170 paediatric patients, summarising the patients' characteristics using descriptive statistics. Binary logistic regression was used to identify factors associated with the development of OM.

Results

At one-week post-HSCT, 41% of 140 patients (n = 49) had developed OM, this was reduced at two-week (n = 36, 33%) and three-week (n = 13, 19%) post-HSCT. Univariate logistic regression revealed that patients with cancer (OR = 0.16, 95% CI = 0.05-0.54; p-value = .003) had a significantly lower prevalence of OM. Younger patients with an average age of 7.9 years old (OR = 0.85, 95% CI = 0.75-0.97; p-value = 0.013) and the presence of GvHD (OR = 2.37, 95% CI = 1.03-5.45, p-value = 0.042) were significantly related to a higher prevalence of OM. Multivariable logistic regression confirmed that the risk of OM is lower in patients with cancer compared to those with immunodeficiency syndromes or hereditary blood diseases (OR = 0.18, 95% CI = 0.04-0.77; p-value = .021).

Conclusions

This study identified a significantly lower prevalence of OM in patients with cancer compared to other conditions and that young recipients and those who developed GvHD were more likely to have OM.

SUBMITTER: Alhussain A

PROVIDER: S-EPMC9291549 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

Prevalence and risk factors of oral mucositis in paediatric patients undergoing haematopoietic stem cell transplantation.

Alhussain Abdulmalik A Alkhayal Zikra Z Ayas Mouhab M Abed Hassan H

Oral diseases 20210202 3

<h4>Background</h4>A complete understanding of oral mucositis (OM) is crucial to develop appropriate interventions to aid in the successful overall health outcome of paediatric patients undergoing haematopoietic stem cell transplantation (HSCT).<h4>Aims</h4>This study aimed at determining the prevalence and severity of OM and at identifying the predictive factors that might aggravate OM at one-week, two-week and three-week post-HSCT.<h4>Methods</h4>This retrospective, hospital-based study review ...[more]

PMID: 33453145

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Project description:IntroductionOral mucositis is a highly prevalent condition in individuals treated for haematological neoplasms, primarily during haematopoietic stem cell transplantation (HSCT). The condition is known to delay recovery processes, increasing the risk of infection, the number of interventions and the length of hospital stays. The proposed Photobiomodulation Therapy for Oral Mucositis and Functional Impairment Transplantation Trial aims to assess the effectiveness and acceptability of using photobiomodulation in the oral cavity to prevent oral mucositis and functional impairment in adult patients undergoing HSCT.Methods and analysisThis is an assessor-blinded and statistician-blinded, parallel-group randomised controlled clinical trial (photobiomodulation vs control group).Participants and setting30 patients, aged 18-65 years, with haematological neoplasms undergoing HSCT at the Clínica Dávila Oncology and Bone Marrow Transplant Unit.Primary outcome measuresoral mucositis will be assessed daily using the WHO grading scale, beginning on the day of transplant through day 20 post-transplant. Researchers will assess functional capacity using a 2 min step test, handgrip strength with the Jamar digital dynamometer, lower limb strength using a 30' sit-to-stand test and quality of life with the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation Questionnaire. Acceptability will be assessed by logging treatment adherence and using a Visual Analogue Scale. Assessments will occur at two time points (1): on admission to the transplant unit, before starting the conditioning regimen and (2) on the day of discharge.Interventionthree times per week photobiomodulation therapy using a diode laser device will begin the first day of conditioning and continue through day 3 post-transplant.Ethics and disseminationThe Clínica Dávila and Universidad del Desarrollo Clinical Research Ethics Committees approved this study in accordance with the Helsinki Declaration. Patients' informed consent will be required. The dissemination strategy includes publication in scientific journals as well as presentations in the media and at conferences.Trial registration numberNCT06260111.

Project description:Epstein-Barr virus (EBV) establishes a lifelong latent infection in healthy humans, kept under immune control by cytotoxic T cells (CTLs). Following paediatric haematopoetic stem cell transplantation (HSCT), a loss of immune surveillance leads to opportunistic outgrowth of EBV-infected cells, resulting in EBV reactivation, which can ultimately progress to post-transplant lymphoproliferative disorder (PTLD). The aims of this study were to identify risk factors for EBV reactivation in children in the first 100 days post-HSCT and to assess the suitability of a previously reported mathematical model to mechanistically model EBV reactivation kinetics in this cohort. Retrospective electronic data were collected from 56 children who underwent HSCT at Great Ormond Street Hospital (GOSH) between 2005 and 2016. Using EBV viral load (VL) measurements from weekly quantitative PCR (qPCR) monitoring post-HSCT, a multivariable Cox proportional hazards (Cox-PH) model was developed to assess time to first EBV reactivation event in the first 100 days post-HSCT. Sensitivity analysis of a previously reported mathematical model was performed to identify key parameters affecting EBV VL. Cox-PH modelling revealed EBV seropositivity of the HSCT recipient and administration of anti-thymocyte globulin (ATG) pre-HSCT to be significantly associated with an increased risk of EBV reactivation in the first 100 days post-HSCT (adjusted hazard ratio (AHR) = 2.32, P = 0.02; AHR = 2.55, P = 0.04). Five parameters were found to affect EBV VL in sensitivity analysis of the previously reported mathematical model. In conclusion, we have assessed the effect of multiple covariates on EBV reactivation in the first 100 days post-HSCT in children and have identified key parameters in a previously reported mechanistic mathematical model that affect EBV VL. Future work will aim to fit this model to patient EBV VLs, develop the model to account for interindividual variability and model the effect of clinically relevant covariates such as rituximab therapy and ATG on EBV VL.

Dataset Information

Prevalence and risk factors of oral mucositis in paediatric patients undergoing haematopoietic stem cell transplantation.

Background

Aims

Methods

Results

Conclusions

Publications

Prevalence and risk factors of oral mucositis in paediatric patients undergoing haematopoietic stem cell transplantation.

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