Effectiveness of palifermin in the prevention of oral mucositis in patients with haematological cancers

Ayago Flores, D.; Ferriols Lisart, R.

doi:10.1016/S2173-5085(10)70009-5

Farmacia Hospitalaria

ISSN: 1130-6343

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Retrospective observational study of cohorts of patients with haematological cancer undergoing cytotoxic therapy causing hematopoietic ablation. The main variable assessed was the duration of the oral mucositis. Secondary variables assessed were incidence of mucositis, febrile or septic neutropenia and the administration of opioids and parenteral nutrition.

Results

We included 36 patients in this study, 11 in the group that received palifermin and 25 in the control group. The duration of oral mucositis was 4.6±3.1 days (median: 5 days) in the patients treated with palifermin in comparison with 7.4±4.0 days (median: 6 days) in patients treated with conventional prophylactic therapy (P<.05). However, no significant differences were seen in the incidence of mucositis, febrile or septic neutropenia, opioid administration of the use of parenteral nutrition.

Conclusions

Prophylactic treatment with palifermin reduces the duration of oral mucosities in patients with haematological cancer. Further studies are necessary with larger samples to be able to assess palifermin and its influence on other variables, such as incidence of mucositis, sepsis, febrile neutropenia, etc.

Keywords:

Mucositis

Keratinocyte growth factor (KGF)

Palifermin

Prevention

Chemotherapy

Haematological cancers

Stem cell transplantation

Resumen

Objetivo

Evaluar la efectividad de la palifermina en la prevención de la mucositis oral (MO) en pacientes oncohematológicos.

Método

Estudio observacional retrospectivo de cohortes en pacientes con neoplasias hematológicas, sometidos a tratamiento mieloablativo de acondicionamiento y posterior trasplante autólogo de progenitores hematopoyéticos, y que reciben como profilaxis de la mucositis palifermina u otro tratamiento convencional. La variable principal evaluada fue la duración de la MO. Las variables secundarias fueron la incidencia de mucositis, neutropenia febril o sepsis y la administración de opiáceos o nutrición parenteral.

Resultados

Se incluyeron 36 pacientes en el estudio, 11 en el grupo de palifermina y 25 en el grupo control. La duración de la MO fue de 4,6±3,1 días (mediana: 5 días) en los pacientes tratados con palifermina respecto a 7,4±4,0 días (mediana: 6 días) en los tratados con profilaxis convencional (p<0,05). A pesar de todo, no se observaron diferencias significativas en la incidencia de mucositis, sepsis o neutropenia febril, la administración de opiáceos o la utilización de nutrición parenteral.

Conclusiones

El tratamiento profiláctico con palifermina permite reducir la duración de la MO en pacientes oncohematológicos. Se necesitan más estudios y con un tamaño muestral mayor para poder evaluar el papel de la palifermina sobre otras variables, tales como la incidencia de la mucositis, sepsis, neutropenia febril, etc.

Palabras clave:

Mucositis

Factor estimulante de queratinocitos

Palifermina

Prevención

Quimioterapia

Neoplasias hematológicas

Trasplante de células madre

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