Abstract

This study was designed to investigate the frequency and severity of oral mucositis in patients with acute myeloid leukemia after allogeneic hematopoietic cell transplantation, in relation to the type of conditioning used. Eighty patients diagnosed with acute myeloid leukemia were assigned to two groups based on the conditioning regimen used before transplantation. The intensity of oral inflammatory lesions induced by chemotherapy (oral mucositis) was evaluated according to a 5-point scale recommended by World Health Organization. Oral mucosa was investigated in all patients before the transplantation and during two subsequent stages of the post-transplantation procedure in relation to the conditioning regimen used. Mucositis in the oral cavity was observed in the majority of patients (66%) in the first week after transplantation, whereas the largest percentage of patients suffering oral lesions (74%) occurred in the second week after transplantation. A significantly higher percentage of patients with mucositis was observed in the group which underwent myeloablation therapy (74% of MAC and 50% of RIC patients in the first week; 83% of MAC and 53% of RIC patients in the second examination).The severity of mucositis after transplantation was higher in the MAC patients compared to the RIC patients. The highest mean value of the mucositis index was recorded in the second week in the MAC group (1.59). In AML sufferers receiving allo-HSCT, oral mucositis is a significant complication of the transplantation. This condition is more frequent and more severe in patients after treatment with myeloablation therapy.

Highlights

  • Acute myeloid leukemia (AML) is a proliferative disease of the hematopoietic system, characterized by uncontrolled clonal proliferation of neoplastic hematopoietic precursors

  • The qualification of patients into MAC and Reduced intensity conditioning (RIC) regimen was performed by hematologist in the Department of Hematology and Bone Marrow Transplantation of PUMS based on the two major criteria: the age of the patient and the presence of concomitant diseases, as evaluated with reference to the hematopoietic cell transplantation-specific comorbidity index (HCTCI) according to Charlson et al [15]

  • When analyzing the incidence of 0° mucositis in relation to the type of conditioning, no significant differences were found between the two groups in the preliminary examination (46 MAC patients, i.e., 85%, 21 RIC patients, i.e., 84%)

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Summary

Introduction

Acute myeloid leukemia (AML) is a proliferative disease of the hematopoietic system, characterized by uncontrolled clonal proliferation of neoplastic hematopoietic precursors. This results in a disturbed production of normal blood cells in blood, bone marrow, and other tissues. AML accounts for about 80% of all acute leukemia cases in adults. AML is currently the leading indication for allogeneic hematopoietic stem cell transplantation (allo-HSCT)

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