Keratinocyte growth factor decreases incidence of severe oral mucositis in children undergoing autologous hematopoietic stem cell transplantation

Abstract

Abstract Introduction Keratinocyte growth factor (palifermin) is used for the prevention of mucositis in adults following autologous and allogeneic hematopoietic stem cell transplantation (HSCT). It is known that palifermin decreases length of initial hospital stay, mean number of days of total parenteral nutrition and the use of opioids for pain control in oral mucositis in adults. There are limited data evaluating palifermin use in children following autologous HSCT. Aim The aim of this study was to analyze the efficacy and safety of palifermin in children and adolescents following autologous HSCT. Material and methods The study included 81 consecutive patients. Results of efficacy and safety of palifermin in 18 patients were compared to data of 63 patients not treated with palifermin. Results and discussion Palifermin decreased the incidence of severe oral mucositis (grade 3–4 WHO) by 19% (44% vs. 63%), however it did not contribute to the duration of oral mucositis and total parenteral nutrition use. There were no differences in opioid use, incidence of fever of unknown origin, severe infection, engraftment and gastrointestinal hemorrhage between groups. Five-year overall survival was better in patients treated with palifermin. Only in one patient generalized, itching rash was observed after palifermin administration. Conclusions Palifermin decreases incidence of severe oral mucositis and improves overall survival in children undergoing autologous HSCT.