Effect of granulocyte- macrophage colony- stimulating factor gargle and deglutition to prevent oral mucositis in patients after conditioning of hematopoietic stem cell transplantation

Objective To observe the effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) gargle and deglutition to prevent oral mucositis (OM) in patients after conditioning of hematopoietic stem cell transplantation (HSCT). Methods From January to December in 2013, in Department of Hepatology, Chinese Academy of Medical Science, Peking Union Medical College Hospital, 74 patients in conditioning of HSCT were divided into treatment group (n=38) and control group (n=36) by random number generator. Sixty-one patients accepted only chemotherapy as conditioning regimen, and total body irradiation plus chemotherapy for the other 13 patients. From the first day of conditioning, the patients of control group accepted routine oral care and chlorhexidine acetate solution gargled three times a day. To the patients of treatment group, 25 mL GM-CSF solution (150 g GM-CSF in 100 mL 0.9% sodium chloride solution) gargle for more than 3 minutes a time and a small deglutition four times a day were added. The differences between the two groups were compared with chi-square test and Mann-Whitney Test. Results The incidence of OM in the treatment group and the control group were 68.4%(26/38) and 72.2%(26/36). There was no significant difference between the two groups(χ2=0.128, P=0.721), either mild or moderate-severe oral mucositis(χ2=1.312, 0.499; P=0.252, 0.480). For the duration of OM, there were no significant differences between the two groups among mild, moderate or severe oral mucositis(Z=-0.900, -0.501, -0.894; P=0.368, 0.616, 0.371). Among 13 patients who received total body irradiation plus chemotherapy, severe OM in the treatment group and the control group were (2/7) and (6/6). There was significant difference between the two groups(χ2=6.964, P=0.008). Conclusion Patients who received total body irradiation and chemotherapy, on the basis of routine oral care, GM-CSF solution gargle and deglutition had some benefit to prevent severe OM. Key words: Granulocyte-macrophage colony-stimulating factor; Hematopoietic stem cell transplantation; Deglutition; Oral mucositis; Gargle