Abstract
Photobiomodulation therapy (PBMT) has demonstrated efficacy in the prevention and treatment of oral mucositis (OM) in hematopoietic cell transplantation (HCT). However, based on the cell stimulation properties, its long-term safety has been questioned, mainly in relation to risk for secondary malignancies in the oral cavity. The aim of this study was to investigate if different PBMT protocols for OM control have association with immediate and late adverse effects in HCT patients. Data on autologous and allogeneic transplantation, conditioning regimen, PBMT protocols, and OM severity were retrospectively collected from medical and dental records. Presence of secondary malignancies in the oral cavity was surveyed during a 15-year follow-up. Impact of OM on overall survival was also analyzed. Different PBMT protocols for prevention and treatment of OM were recorded over the years. Severe OM (grades 3 and 4) was infrequently observed. When present, we observed a significant decrease of the overall survival. No immediate adverse effect and secondary malignancy was associated to PBMT. In conclusion, the PBMT protocols used in the study were considered safe. The low frequency of severe OM observed encourages the implementation of this technique, with a special emphasis on the dosimetry adjustments focused on the HCT context.
Highlights
Hematopoietic cell transplantation (HCT) is a consolidation treatment for diseases in which there is a failure and/or deficiency of the hematopoietic system, including both neoplastic and non-neoplastic disorders
This was a single center retrospective, observational study carried out using data collected from medical and dental records of patients treated at the Bone Marrow Transplant Center at Hospital Israelita Albert Einstein (HIAE)
We aimed to evaluate the short and long-term safety of the Photobiomodulation therapy (PBMT) in prevention and treatment of Oral mucositis (OM) in HCT patients
Summary
Hematopoietic cell transplantation (HCT) is a consolidation treatment for diseases in which there is a failure and/or deficiency of the hematopoietic system, including both neoplastic and non-neoplastic disorders. HCT procedure includes the reduction of bone marrow cellularity by means of conditioning with high doses of chemotherapy and or radiotherapy, followed by an infusion with normal stem cells. The HCT conditioning causes high toxicity and prolonged immunosuppression, predisposing the patient to infections and injuries in several tissues. Oral mucositis (OM) is an important dose-limiting adverse event that occurs immediately after the HCT. OM is a painful inflammatory condition that can impair the oral intake, and compromise the patients quality of life. Ulcerated OM favors secondary oral infections, increasing the risk of bacteremia and sepsis in the immunocompromised patients (Elad et al, 2015)
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