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Prevention of oral mucositis with cryotherapy in children undergoing hematopoietic stem cell transplantations: A feasibility study and randomized controlled trial feasibility study and randomized controlled trial
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.ORCID iD: 0000-0003-2696-4054
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Department of Dental Medicine, Karolinska Institutet.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Neuropediatrics/Paediatric oncology.
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2020 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339Article in journal (Refereed) Published
Abstract [en]

Purpose

To evaluate the feasibility of oral cryotherapy (OC) in children and to investigate if OC reduces the incidence of severe oral mucositis (OM), oral pain, and opioid use in children undergoing hematopoietic stem cell transplantation (HSCT).

Methods

Fifty-three children, 4–17 years old, scheduled for HSCT in Sweden were included and randomized to OC or control using a computer-generated list. OC instructions were to cool the mouth with ice for as long as possible during chemotherapy infusions with an intended time of ≥ 30 min. Feasibility criteria in the OC group were as follows: (1) compliance ≥ 70%; (2) considerable discomfort during OC < 20%; (3) no serious adverse events; and (4) ice administered to all children. Grade of OM and oral pain was recorded daily using the WHO-Oral Toxicity Scale (WHO-OTS), Children’s International Oral Mucositis Evaluation Scale, and Numerical Rating Scale. Use of opioids was collected from the medical records.

Results

Forty-nine children (mean age 10.5 years) were included in analysis (OC = 26, control = 23). The feasibility criteria were not met. Compliance was poor, especially for the younger children, and only 15 children (58%) used OC as instructed. Severe OM (WHO-OTS ≥ 3) was recorded in 26 children (OC = 15, control = 11). OC did not reduce the incidence of severe OM, oral pain, or opioid use.

Conclusion

The feasibility criteria were not met, and the RCT could not show that OC reduces the incidence of severe OM, oral pain, or opioid use in pediatric patients treated with a variety of conditioning regimens for HSCT.

Place, publisher, year, edition, pages
2020.
Keywords [en]
Oral mucositis, Children, Hematopoietic stem cell transplantation, Oral cryotherapy, Feasibility
National Category
Pediatrics Cancer and Oncology
Research subject
Pediatrics; Oncology
Identifiers
URN: urn:nbn:se:uu:diva-404273DOI: 10.1007/s00520-019-05258-2OAI: oai:DiVA.org:uu-404273DiVA, id: diva2:1393554
Funder
Swedish Childhood Cancer FoundationSwedish Cancer SocietyAvailable from: 2020-02-17 Created: 2020-02-17 Last updated: 2020-02-18Bibliographically approved

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Kamsvåg Magnusson, ToveSvanberg, AnncarinArvidson, Johanvon Essen, LouiseLjungman, Gustaf

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Kamsvåg Magnusson, ToveSvanberg, AnncarinArvidson, Johanvon Essen, LouiseLjungman, Gustaf
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Department of Women's and Children's HealthCaring SciencesNeuropediatrics/Paediatric oncologyClinical Psychology in Healthcare
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Supportive Care in Cancer
PediatricsCancer and Oncology

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