PС-04. Comparison of chlorhexidine and Ringer’s solution efficiency for the prevention of oral mucositis in the early posttransplant period in adults
Feruza A. Omarova, Mikhail Yu. Drokov, Natalia N. Popova, Zoya V. Konova, Mobil I. Akhmedov, Olga S. Starikova, Ulyana V. Maslikova, Elmira I. Kolgaeva, Ekaterina D. Mikhaltsova, Mariya V. Dovydenko, Olga M. Koroleva, Anna A. Dmitrova, Darya S. Dubnyak, Vera A. Vasilyeva, Larisa A. Kuzmina, Elena N. Parovichnikova, Valery G. Savchenko
National Research Center for Hematology, Moscow, Russian Federation
Contact: Dr. Mikhail Yu. Drokov, phone: +7 (495) 614 9042, e-mail: mdrokov@gmail.com
Summary
Introduction
Mucositis is one of the most common complications after allo-HSCT. The clinical presentation of oral mucositis can range from diffuse hyperemia to multiple ulcers with necrosis, accompanied by intense pain syndrome requiring treatment with opioids. Despite such a high frequency of this problem among patients after allo-HSCT, there are currently no recommendations or studies showing the benefits of a particular methods of prevention/treatment. Chlorhexidine, the most common drug in Russia, is ineffective, according to Foote et al. No advantage was observed with Kaposol use in randomized studies (Treister et al., 2017). Considering a similarity of Ringer’s solution to the available commercial drugs, we conducted a study to compare the effectiveness of chlorhexidine and Ringer’s solution for oral mucositis prophylaxis. Our objective was to compare effectiveness of chlorhexidine and Ringer’s solution for the oral mucositis prophylaxis.
Materials and methods
The study included 29 patients with hematological malignancies, who underwent allo-HSCT with reduced-intensity conditioning (RIC) – fludarabine+busulfan (fludarabine 180 mg/m2, busulfan 8 mg/kg). The patients were randomly assigned to either mouth rinse with chlorhexidine or Ringer’s solution for mucositis prophylaxis. Patients from both groups were prescribed to rinse the mouth with 15 ml of the solution for 1 minute 4 times a day regularly, starting from the onset of pretransplant conditioning until neutrophil engraftment. Once in 5 days, mucositis was assessed according to National Cancer Institute Common Toxicology Criteria (NCI-CTC) oral mucositis clinical grading scale, National Cancer Institute Common Toxicology Criteria (NCI-CTC) oral mucositis functional grading scale, World Health Organization (WHO) oral mucositis grading scale. If no compliance was observed, the patient was excluded from observation. Statistical analysis was carried out using IBM SPSS v.23 (USA). Chi-square test was used to test the variables. P-value <0.05 was considered statistically significant.
Results
The results of the study are presented in Figure 1. No significant difference could be detected in the severity of any of the analyzed parameters, thus indicating acceptability of the both drugs without any sufficient differences observed.
Figure 1. Comparison of the incidence of oral mucositis depending on the type of prophylaxis
Conclusion
In this study, we were unable to show any advantage of preventing oral mucositis with Ringer’s solution against chlorhexidine in adult patients after allo-HCT.
Keywords
Hematopoietic stem cell transplantation, oral mucositis, prophylaxis, treatment.
