PMID- 26190358 OWN - NLM STAT- MEDLINE DCOM- 20160809 LR - 20220318 IS - 1433-7339 (Electronic) IS - 0941-4355 (Print) IS - 0941-4355 (Linking) VI - 24 IP - 2 DP - 2016 Feb TI - CD34+ selection and the severity of oropharyngeal mucositis in total body irradiation-based allogeneic stem cell transplantation. PG - 815-822 LID - 10.1007/s00520-015-2848-9 [doi] AB - OBJECTIVE: The purpose of the present study was to evaluate the impact of ex vivo T cell depleted (TCD) by CD34+ selection on the incidence and severity of oropharyngeal mucositis (OM) after myeloablative allogeneic stem cell transplant (allo-SCT) with total body irradiation (TBI) conditioning. This approach has the advantage of avoiding methotrexate for graft versus host disease (GVHD) prophylaxis. PATIENTS AND METHODS: We analyzed the incidence and severity of OM in a cohort of 105 consecutive patients who underwent CD34+ selected (peripheral blood stem cells (PBSCs) from human leukocyte antigen (HLA)-identical siblings) allo-SCT with total body irradiation (TBI) conditioning. OM was graded by the World Health organization (WHO) and the Bearman regimen-related toxicity (RRT) scales. RESULTS: The incidence of WHO grade 3-4 OM was 34.3 %. There were no cases of grade 3-4 OM by the RRT scale. Significant correlation was found between the severity of OM and the use of intravenous (IV) narcotic medications (r (2) = 0.15, p = 0.004), total parenteral nutrition (TPN; r (2) = 0.68, p < 0.001), and hospital length of stay (LOS) (r (2) = 0.12, p = 0.01). DISCUSSION: TBI-induced OM can inflict significant morbidity in the early transplant period, and the incidence of WHO grade 3-4 OM can exceed 50 % when methotrexate is used for GVHD prophylaxis. In the CD34+ selected setting, methotrexate is avoided and the incidence of WHO grade 3-4 OM, use of TPN, and need for narcotic analgesia appear to be lower than historic evidence from standard T-replete allogeneic transplantation. CONCLUSION: We conclude that toxicity from OM is tolerable in CD34+ selected allo-SCT and should be prospectively measured in randomized trials comparing CD34+ selection versus T-replete transplantation. FAU - Anand, Ankit AU - Anand A AD - Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Anandi, Prathima AU - Anandi P AD - Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Jain, Natasha A AU - Jain NA AD - Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Lu, Kit AU - Lu K AD - Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Dunavin, Neil AU - Dunavin N AD - Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Hourigan, Christopher S AU - Hourigan CS AD - Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Le, Robert Q AU - Le RQ AD - Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Chokshi, Puja D AU - Chokshi PD AD - Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Ito, Sawa AU - Ito S AD - Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Stroncek, David F AU - Stroncek DF AD - Cell Processing Section, Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA. FAU - Sabatino, Marianna AU - Sabatino M AD - Cell Processing Section, Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA. FAU - Barrett, A John AU - Barrett AJ AD - Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Battiwalla, Minoo AU - Battiwalla M AD - Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. minoo.battiwalla@nih.gov. LA - eng GR - Z99 HL999999/Intramural NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Intramural DEP - 20150721 PL - Germany TA - Support Care Cancer JT - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer JID - 9302957 RN - 0 (Antigens, CD34) SB - IM MH - Adult MH - Antigens, CD34/*blood MH - Female MH - Graft vs Host Disease/drug therapy MH - Hematopoietic Stem Cell Transplantation/*adverse effects MH - Humans MH - Male MH - Middle Aged MH - Mouth Diseases/*etiology MH - Mucositis/*etiology MH - Pharyngeal Diseases/*etiology MH - Severity of Illness Index MH - T-Lymphocytes/immunology MH - Transplantation Conditioning/*adverse effects MH - Transplantation, Homologous MH - Whole-Body Irradiation/*methods PMC - PMC4690764 MID - NIHMS709542 OTO - NOTNLM OT - Allogeneic OT - CD34 selection OT - Methotrexate OT - Oral mucositis OT - Oropharyngeal mucositis OT - Quality of life OT - Stem cell transplant OT - T cell depleted transplantation OT - Total body irradiation COIS- Conflict-of-interest disclosure: The authors have no conflicts of interest to disclose. EDAT- 2015/07/21 06:00 MHDA- 2016/08/10 06:00 PMCR- 2017/02/01 CRDT- 2015/07/21 06:00 PHST- 2015/03/09 00:00 [received] PHST- 2015/07/06 00:00 [accepted] PHST- 2015/07/21 06:00 [entrez] PHST- 2015/07/21 06:00 [pubmed] PHST- 2016/08/10 06:00 [medline] PHST- 2017/02/01 00:00 [pmc-release] AID - 10.1007/s00520-015-2848-9 [pii] AID - 10.1007/s00520-015-2848-9 [doi] PST - ppublish SO - Support Care Cancer. 2016 Feb;24(2):815-822. doi: 10.1007/s00520-015-2848-9. Epub 2015 Jul 21.