Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation: Clinical outcomes in a context of specialized oral care using low-level laser therapy

Fernanda De Paula Eduardo, Leticia Mello Bezinelli, Danielle Lima Corrêa De Carvalho, Roberta Marques Da Graça Lopes, Juliana Folloni Fernandes, Melina Brumatti, Carolina Sgaroni Camargo Vince, Alessandra Milani Prandini De Azambuja, Cristina Vogel, Nelson Hamerschlak, Luciana Correa

Research output: Contribution to journalArticle

  • 14 Citations

Abstract

OM is a painful inflammatory condition of the oral mucosa, derived from the toxic effects of chemotherapy and radiotherapy. High OM severity is frequently present in HSCT pediatric patients, who exhibit multiple painful ulcers that limit their mastication and swallowing, leading to poor nutritional status. Few studies have demonstrated OM clinical outcomes in young patients undergoing HSCT. Feasibility of oral care and LLLT on OM prophylaxis and treatment is also poorly discussed. The aim of this study was to describe a specialized oral care protocol that included LLLT for pediatric patients undergoing transplantation and to demonstrate the clinical outcomes after OM prevention and treatment. Data from OM-related morbidity were collected from 51 HSCT pediatric patients treated daily with LLLT, followed by standard oral care protocols. All the patients, even infants and young children, accepted the daily oral care and LLLT well. The majority (80.0%) only exhibited erythema in the oral mucosa, and the maximum OM degree was WHO II. Patients who had undergone autologous and HLA-haploidentical transplants showed OM with the lowest severity. The frequency of total body irradiation and methotrexate prescriptions was higher in adolescents when compared with infants (p = 0.044), and adolescents also exhibited OM more severely than infants and young children. We found that good clinical outcomes were obtained using this therapy, mainly in regard to the control of OM severity and pain reduction in the oral cavity. Specialized oral care, including LLLT, is feasible and affordable for HSCT pediatric patients, although some adaptation in the patient's oral hygiene routine must be adopted with help from parents/companions and clinical staff.

LanguageEnglish (US)
Pages316-325
Number of pages10
JournalPediatric Transplantation
Volume19
Issue number3
DOIs
StatePublished - May 1 2015

Fingerprint

Stomatitis
Hematopoietic Stem Cell Transplantation
Pediatrics
Mouth Mucosa
Low-Level Light Therapy
Whole-Body Irradiation
Oral Hygiene
Poisons
Mastication
Erythema
Deglutition
Nutritional Status
Methotrexate
Ulcer
Prescriptions
Mouth
Radiotherapy
Therapeutics
Transplantation
Parents

Keywords

  • hematopoietic stem cell transplantation
  • low-level laser therapy
  • oral health care
  • oral mucositis
  • pediatric patients

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation : Clinical outcomes in a context of specialized oral care using low-level laser therapy. / Eduardo, Fernanda De Paula; Bezinelli, Leticia Mello; De Carvalho, Danielle Lima Corrêa; Lopes, Roberta Marques Da Graça; Fernandes, Juliana Folloni; Brumatti, Melina; Vince, Carolina Sgaroni Camargo; De Azambuja, Alessandra Milani Prandini; Vogel, Cristina; Hamerschlak, Nelson; Correa, Luciana.

In: Pediatric Transplantation, Vol. 19, No. 3, 01.05.2015, p. 316-325.

Research output: Contribution to journalArticle

Eduardo, FDP, Bezinelli, LM, De Carvalho, DLC, Lopes, RMDG, Fernandes, JF, Brumatti, M, Vince, CSC, De Azambuja, AMP, Vogel, C, Hamerschlak, N & Correa, L 2015, 'Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation: Clinical outcomes in a context of specialized oral care using low-level laser therapy' Pediatric Transplantation, vol. 19, no. 3, pp. 316-325. https://doi.org/10.1111/petr.12440
Eduardo, Fernanda De Paula ; Bezinelli, Leticia Mello ; De Carvalho, Danielle Lima Corrêa ; Lopes, Roberta Marques Da Graça ; Fernandes, Juliana Folloni ; Brumatti, Melina ; Vince, Carolina Sgaroni Camargo ; De Azambuja, Alessandra Milani Prandini ; Vogel, Cristina ; Hamerschlak, Nelson ; Correa, Luciana. / Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation : Clinical outcomes in a context of specialized oral care using low-level laser therapy. In: Pediatric Transplantation. 2015 ; Vol. 19, No. 3. pp. 316-325.
@article{e3be2485de974a7f9d8ba86163bfa608,
title = "Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation: Clinical outcomes in a context of specialized oral care using low-level laser therapy",
abstract = "OM is a painful inflammatory condition of the oral mucosa, derived from the toxic effects of chemotherapy and radiotherapy. High OM severity is frequently present in HSCT pediatric patients, who exhibit multiple painful ulcers that limit their mastication and swallowing, leading to poor nutritional status. Few studies have demonstrated OM clinical outcomes in young patients undergoing HSCT. Feasibility of oral care and LLLT on OM prophylaxis and treatment is also poorly discussed. The aim of this study was to describe a specialized oral care protocol that included LLLT for pediatric patients undergoing transplantation and to demonstrate the clinical outcomes after OM prevention and treatment. Data from OM-related morbidity were collected from 51 HSCT pediatric patients treated daily with LLLT, followed by standard oral care protocols. All the patients, even infants and young children, accepted the daily oral care and LLLT well. The majority (80.0{\%}) only exhibited erythema in the oral mucosa, and the maximum OM degree was WHO II. Patients who had undergone autologous and HLA-haploidentical transplants showed OM with the lowest severity. The frequency of total body irradiation and methotrexate prescriptions was higher in adolescents when compared with infants (p = 0.044), and adolescents also exhibited OM more severely than infants and young children. We found that good clinical outcomes were obtained using this therapy, mainly in regard to the control of OM severity and pain reduction in the oral cavity. Specialized oral care, including LLLT, is feasible and affordable for HSCT pediatric patients, although some adaptation in the patient's oral hygiene routine must be adopted with help from parents/companions and clinical staff.",
keywords = "hematopoietic stem cell transplantation, low-level laser therapy, oral health care, oral mucositis, pediatric patients",
author = "Eduardo, {Fernanda De Paula} and Bezinelli, {Leticia Mello} and {De Carvalho}, {Danielle Lima Corr{\^e}a} and Lopes, {Roberta Marques Da Gra{\cc}a} and Fernandes, {Juliana Folloni} and Melina Brumatti and Vince, {Carolina Sgaroni Camargo} and {De Azambuja}, {Alessandra Milani Prandini} and Cristina Vogel and Nelson Hamerschlak and Luciana Correa",
year = "2015",
month = "5",
day = "1",
doi = "10.1111/petr.12440",
language = "English (US)",
volume = "19",
pages = "316--325",
journal = "Pediatric Transplantation",
issn = "1397-3142",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation

T2 - Pediatric Transplantation

AU - Eduardo, Fernanda De Paula

AU - Bezinelli, Leticia Mello

AU - De Carvalho, Danielle Lima Corrêa

AU - Lopes, Roberta Marques Da Graça

AU - Fernandes, Juliana Folloni

AU - Brumatti, Melina

AU - Vince, Carolina Sgaroni Camargo

AU - De Azambuja, Alessandra Milani Prandini

AU - Vogel, Cristina

AU - Hamerschlak, Nelson

AU - Correa, Luciana

PY - 2015/5/1

Y1 - 2015/5/1

N2 - OM is a painful inflammatory condition of the oral mucosa, derived from the toxic effects of chemotherapy and radiotherapy. High OM severity is frequently present in HSCT pediatric patients, who exhibit multiple painful ulcers that limit their mastication and swallowing, leading to poor nutritional status. Few studies have demonstrated OM clinical outcomes in young patients undergoing HSCT. Feasibility of oral care and LLLT on OM prophylaxis and treatment is also poorly discussed. The aim of this study was to describe a specialized oral care protocol that included LLLT for pediatric patients undergoing transplantation and to demonstrate the clinical outcomes after OM prevention and treatment. Data from OM-related morbidity were collected from 51 HSCT pediatric patients treated daily with LLLT, followed by standard oral care protocols. All the patients, even infants and young children, accepted the daily oral care and LLLT well. The majority (80.0%) only exhibited erythema in the oral mucosa, and the maximum OM degree was WHO II. Patients who had undergone autologous and HLA-haploidentical transplants showed OM with the lowest severity. The frequency of total body irradiation and methotrexate prescriptions was higher in adolescents when compared with infants (p = 0.044), and adolescents also exhibited OM more severely than infants and young children. We found that good clinical outcomes were obtained using this therapy, mainly in regard to the control of OM severity and pain reduction in the oral cavity. Specialized oral care, including LLLT, is feasible and affordable for HSCT pediatric patients, although some adaptation in the patient's oral hygiene routine must be adopted with help from parents/companions and clinical staff.

AB - OM is a painful inflammatory condition of the oral mucosa, derived from the toxic effects of chemotherapy and radiotherapy. High OM severity is frequently present in HSCT pediatric patients, who exhibit multiple painful ulcers that limit their mastication and swallowing, leading to poor nutritional status. Few studies have demonstrated OM clinical outcomes in young patients undergoing HSCT. Feasibility of oral care and LLLT on OM prophylaxis and treatment is also poorly discussed. The aim of this study was to describe a specialized oral care protocol that included LLLT for pediatric patients undergoing transplantation and to demonstrate the clinical outcomes after OM prevention and treatment. Data from OM-related morbidity were collected from 51 HSCT pediatric patients treated daily with LLLT, followed by standard oral care protocols. All the patients, even infants and young children, accepted the daily oral care and LLLT well. The majority (80.0%) only exhibited erythema in the oral mucosa, and the maximum OM degree was WHO II. Patients who had undergone autologous and HLA-haploidentical transplants showed OM with the lowest severity. The frequency of total body irradiation and methotrexate prescriptions was higher in adolescents when compared with infants (p = 0.044), and adolescents also exhibited OM more severely than infants and young children. We found that good clinical outcomes were obtained using this therapy, mainly in regard to the control of OM severity and pain reduction in the oral cavity. Specialized oral care, including LLLT, is feasible and affordable for HSCT pediatric patients, although some adaptation in the patient's oral hygiene routine must be adopted with help from parents/companions and clinical staff.

KW - hematopoietic stem cell transplantation

KW - low-level laser therapy

KW - oral health care

KW - oral mucositis

KW - pediatric patients

UR - http://www.scopus.com/inward/record.url?scp=84925873868&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925873868&partnerID=8YFLogxK

U2 - 10.1111/petr.12440

DO - 10.1111/petr.12440

M3 - Article

VL - 19

SP - 316

EP - 325

JO - Pediatric Transplantation

JF - Pediatric Transplantation

SN - 1397-3142

IS - 3

ER -