11 mei 2005: Bron: Bone Marrow Transplant. 2006 Apr 24;

Wanneer tijdens de toediening van Melphalan, een chemo ter voorbereiding van een beenmergtransplantatie, oraal cryotherapie wordt gegeven, treedt er daarna hoog significant minder mucositis - aantasting van het slijmvlies in de mond - op bij de Kahler patiënten. Ook zijn er minder pijnklachten en was de lichamelijke activiteit van de patiënt beter. Kwaliteit van leven en het verdragen van de beenmergtransplantatie was dus beide aanzienlijk beter. Deze bevindingen zijn al eerder gevonden in eerdere studies, zie daarvoor literatuurlijst van arts-bioloog drs. E. Valstar no. 1074 en 1151.

A prospective, randomized study of cryotherapy during administration of high-dose melphalan to decrease the severity and duration of oral mucositis in patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation. Lilleby K, Garcia P, Gooley T, McDonnnell P, Taber R, Holmberg L, Maloney DG, Press OW, Bensinger W. 1Fred Hutchinson Cancer Research Center, the Seattle Cancer Care Alliance and the University of Washington, Seattle, WA, USA. Forty patients with multiple myeloma scheduled to receive melphalan 200 mg/m(2) followed by autologous stem cell transplantation were randomly assigned to receive oral cryotherapy or room temperature normal saline rinses 30 min before and for 6 h after high-dose therapy. Patients were evaluated for the development of mucositis using the National Cancer Institute grading system as well as evaluation of secondary measures such as days of total parenteral nutrition (TPN), narcotic use, hospitalization, weight loss and resumption of oral caloric intake for 28 days after transplant. Patients self-scored their pain, swallowing, drinking, eating, sleeping and taste alterations for 28 days.

The primary end point of this trial was the incidence of grades 3-4 mucositis. Compared to the normal saline group, patients using cryotherapy experienced less grade 3-4 mucositis, 14 vs 74%, P=0.0005. Patients receiving cryotherapy also had statistically lower uses of narcotics and TPN, although there were no differences in length of hospitalization or weight loss. Patient-reported pain was significantly lower and activities were significantly better in the cryotherapy group.

Bone Marrow Transplantation advance online publication, 24 April 2006; doi:10.1038/sj.bmt.1705384. PMID: 16633359 [PubMed - as supplied by publisher]

chemo, beenmergtransplantatie, Cryotherapoie, mucositis, melphalan


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