Photo-Biomodulation as a Prevention Modality of Oral Mucositis in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Routine Oral Care
2.2. PBM Parameters
2.3. Assessment of OM
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | Preventive Group (PG) | Control Group (CG) |
---|---|---|
Mean age (range) | 46.5 (7–66) | 45.6 (19–65) |
Gender | n (%) | n (%) |
Male | 13 (65) | 10 (50) |
Female | 7 (35) | 10 (50) |
Type of aHSCT | ||
Matched Unrelated Donor (MUD) | 14 (70) | 9 (45) |
Matched Related Donor (MRD) | 6 (30) | 11 (55) |
Underlying Pathology | ||
Acute Lymphocytic Leukemia | 3 (15) | 4 (20) |
Acute Myelogenous Leukemia (AML) | 3 (15) | 7 (35) |
Myelofibrosis | 3 (15) | 3 (15) |
Myelodisplastic Syndrome | 3 (15) | 1 (5) |
Chronic Myelogenous Leukemia | 2 (10) | - |
Non-Hodgkin’s Lymphoma | - | 2 (10) |
Multiple Myeloma | 1 (5) | - |
Myeloid Sarcoma (MS) | 1 (5) | - |
Mixed Phenotype Acute Leukemia | 1 (5) | - |
Chronic Lymphocytic Leukemia | - | 1 (5) |
T-cell prolymphocytic leukemia | - | 1 (5) |
Aplastic Anemia | - | 1 (5) |
MS and AML | 1 (5) | - |
Others | 2 (10) | - |
aHSCT Conditioning Regimen | ||
Thio, BUS, FLU, Meth | 14 (70) | 11 (55) |
Thio, BUS, FLU, Cyclo | 4 (20) | 5 (25) |
TBI, Thio, FLU, Meth | 1 (5) | - |
Thio, FLU, and Meth | 1 (5) | - |
Treo, FLU | - | 1 (5) |
Rituximab, Cyclo, Thio, Cyclosporine | - | 1 (5) |
Cyclo, Meth | - | 1 (5) |
Cyclosporine, Thio, FLU, Cyclo | - | 1 (5) |
Manufacturer | FISIOLINE |
Model identifier | Lumix2® (Double diode laser) |
Number and type of emitters | Two wavelengths, visible GaAs and infrared GaAs |
Wavelength and bandwidth | 650 nm, and 904–910 nm |
Pulse mode | For visible 650 nm: continuous mode and for 904–910 nm: 13 kHz |
Beam spot size at target | ~0.5 cm2 |
Exposure duration | 45 s per point |
Number of points irradiated | 10 points intraorally including buccal mucosa, tip, ventral and marginal surface of the tongue, floor of the mouth, soft palate, and inner surfaces of the lip. |
Area irradiated | ~5 cm2 |
Application technique | Point by point in a defocused mode |
Total irradiation energy per session | 40 J |
Number and frequency of treatment sessions | 5 sessions per week (Monday to Friday) starting one day before the conditioning regimen and continued till the 10th day after transplantation (D+10) |
Variables | Preventive Group (PG)Median ± SD | Control Group (CG)Median ± SD | p-Value |
---|---|---|---|
Age | 46.5 ± 14.43 | 45.55 ± 16.01 | 0.914 |
Max grade of oral mucositis | 1.00 ± 0.92 | 2.25 ± 0.85 | <0.001 * |
Duration of oral mucositis of: | |||
Grade 0 | 17.30 ± 3.03 | 11.00 ± 5.20 | <0.001 * |
Grade I | 2.15 ± 2.81 | 6.30 ± 3.42 | <0.001 * |
Grade II | 2.20 ± 2.97 | 5.70 ± 6.16 | 0.025 * |
Grade III | 0.00 ± 0.00 | 2.0 ± 4.36 | 0.009 * |
Grade IV | 0.00 ± 0.00 | 0.55 ± 1.76 | 0.152 |
Total duration of oral mucositis | 4.70 ± 5.05 | 15.00 ± 8.83 | <0.001 * |
Mean oral mucositis score at Evaluation time points (E): | |||
E0 | 0.05 ± 0.22 | 0.15 ± 0.37 | 0.298 |
E1 | 0.05 ± 0.22 | 0.55 ± 0.83 | 0.008 * |
E2 | 0.56 ± 0.68 | 1.25 ± 1.12 | 0.005 * |
E3 | 0.95 ± 0.94 | 1.35 ± 1.14 | 0.307 |
E4 | 0.45 ± 0.69 | 1.25 ± 1.21 | 0.022 * |
E5 | 0.00 ± 0.00 | 1.05 ± 0.94 | <0.001 * |
Variables | Preventive Group (PG) | Control Group (CG) | χ2 | p-Value |
---|---|---|---|---|
Severity of Oral Mucositis (OM) | ||||
Non-ulcerative OM (≤ Grade I) | 12 | 3 | 8424 | 0.003 * |
Ulcerative OM (≥ Grade II) | 8 | 17 | ||
Incidence of OM | ||||
No OM (Grade 0) | 8 | 0 | 10,000 | 0.002 * |
With OM (≥ Grade I) | 12 | 20 |
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Mohsen, A.; Tenore, G.; Rocchetti, F.; Del Vecchio, A.; Ricci, R.; Barberi, W.; Cartoni, C.; Iori, A.P.; Pippi, R.; Polimeni, A.; et al. Photo-Biomodulation as a Prevention Modality of Oral Mucositis in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation. Appl. Sci. 2020, 10, 7479. https://doi.org/10.3390/app10217479
Mohsen A, Tenore G, Rocchetti F, Del Vecchio A, Ricci R, Barberi W, Cartoni C, Iori AP, Pippi R, Polimeni A, et al. Photo-Biomodulation as a Prevention Modality of Oral Mucositis in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation. Applied Sciences. 2020; 10(21):7479. https://doi.org/10.3390/app10217479
Chicago/Turabian StyleMohsen, Ahmed, Gianluca Tenore, Federica Rocchetti, Alessandro Del Vecchio, Roberto Ricci, Walter Barberi, Claudio Cartoni, Anna Paola Iori, Roberto Pippi, Antonella Polimeni, and et al. 2020. "Photo-Biomodulation as a Prevention Modality of Oral Mucositis in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation" Applied Sciences 10, no. 21: 7479. https://doi.org/10.3390/app10217479
APA StyleMohsen, A., Tenore, G., Rocchetti, F., Del Vecchio, A., Ricci, R., Barberi, W., Cartoni, C., Iori, A. P., Pippi, R., Polimeni, A., & Romeo, U. (2020). Photo-Biomodulation as a Prevention Modality of Oral Mucositis in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation. Applied Sciences, 10(21), 7479. https://doi.org/10.3390/app10217479