Oral mucositis in myeloma patients undergoing melphalan-based autologous stem cell transplantation: Incidence, risk factors and a severity predictive model

M. L. Grazziutti, L. Dong, M. H. Miceli, S. G. Krishna, E. Kiwan, N. Syed, A. Fassas, F. van Rhee, H. Klaus, B. Barlogie, E. J. Anaissie

Research output: Contribution to journalArticle

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Abstract

Melphalan-based autologous stem cell transplant (Mel-ASCT) is a standard therapy for multiple myeloma, but is associated with severe oral mucositis (OM). To identify predictors for severe OM, we studied 381 consecutive newly diagnosed myeloma patients who received Mel-ASCT. Melphalan was given at 200 mg/m2 body surface area (BSA), reduced to 140 mg/m2 for serum creatinine > 3 mg/dl. Potential covariates included demographics, pre-transplant serum albumin and renal and liver function tests, and mg/kg melphalan dose received. The BSA dosing resulted in a wide range of melphalan doses given (2.4-6.2 mg/kg). OM developed in 75% of patients and was severe in 21%. Predictors of severe OM in multiple logistic regression analyses were high serum creatinine (odds ratio (OR = 1.581; 95% confidence interval (CI): 1.080-2.313; P = 0.018) and high mg/kg melphalan (OR = 1.595; 95% CI: 1.065-2.389; P = 0.023). An OM prediction model was developed based on these variables. We concluded that BSA dosing of melphalan results in wide variations in the mg/kg dose, and that patients with renal dysfunction who are scheduled to receive a high mg/kg melphalan dose have the greatest risk for severe OM following Mel-ASCT. Pharmacogenomic and pharmacokinetic studies are needed to better understand interpatient variability of melphalan exposure and toxicity.

Original languageEnglish (US)
Pages (from-to)501-506
Number of pages6
JournalBone Marrow Transplantation
Volume38
Issue number7
DOIs
StatePublished - Oct 2006

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Stomatitis
Melphalan
Stem Cell Transplantation
Incidence
Body Surface Area
Transplants
Stem Cells
Creatinine
Confidence Intervals
Kidney
Liver Function Tests
Serum
Multiple Myeloma
Serum Albumin
Pharmacokinetics
Logistic Models
Odds Ratio
Regression Analysis
Demography

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Oral mucositis in myeloma patients undergoing melphalan-based autologous stem cell transplantation : Incidence, risk factors and a severity predictive model. / Grazziutti, M. L.; Dong, L.; Miceli, M. H.; Krishna, S. G.; Kiwan, E.; Syed, N.; Fassas, A.; van Rhee, F.; Klaus, H.; Barlogie, B.; Anaissie, E. J.

In: Bone Marrow Transplantation, Vol. 38, No. 7, 10.2006, p. 501-506.

Research output: Contribution to journalArticle

Grazziutti, ML, Dong, L, Miceli, MH, Krishna, SG, Kiwan, E, Syed, N, Fassas, A, van Rhee, F, Klaus, H, Barlogie, B & Anaissie, EJ 2006, 'Oral mucositis in myeloma patients undergoing melphalan-based autologous stem cell transplantation: Incidence, risk factors and a severity predictive model', Bone Marrow Transplantation, vol. 38, no. 7, pp. 501-506. https://doi.org/10.1038/sj.bmt.1705471
Grazziutti, M. L. ; Dong, L. ; Miceli, M. H. ; Krishna, S. G. ; Kiwan, E. ; Syed, N. ; Fassas, A. ; van Rhee, F. ; Klaus, H. ; Barlogie, B. ; Anaissie, E. J. / Oral mucositis in myeloma patients undergoing melphalan-based autologous stem cell transplantation : Incidence, risk factors and a severity predictive model. In: Bone Marrow Transplantation. 2006 ; Vol. 38, No. 7. pp. 501-506.
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