Photobiomodulation: a promising innovative approach for preventing oral mucositis in patients undergoing hematopoietic stem cell transplantation

Support Care Cancer. 2022 Oct;30(10):8211-8216. doi: 10.1007/s00520-022-07280-3. Epub 2022 Jul 9.

Abstract

Purpose: This single-center retrospective study aims to assess the feasibility, safety, and tolerability of CareMin650, a new photobiomodulation device, for both preventing oral mucositis (OM) and reducing its severity in the setting of hematopoietic stem cell transplantation (HCT).

Methods: Patients who underwent autologous HCT for hematological malignancies between November 2020 and October 2021 could be included. Prophylactic photobiomodulation (PBM) was used daily from day 1 of conditioning until the day of neutrophil recovery at a dose of 3 J/cm2. Curative PBM was started at a dose of 6 J/cm2 when at least one grade 1 OM had occurred. For each OM case, time of onset, National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0 grade for OM, analgesic dose, and time to resolution were reported.

Results: Twenty-five consecutive patients were included. The median age was 58 years (range, 39-74) and 14 (56%) were male. Twenty-one patients (84%) received a high-dose melphalan conditioning regimen for multiple myeloma, and 4 (16%) patients received BEAM conditioning for aggressive lymphoma. A total of 178 CareMin650 sessions were performed, with a median of 7 days of application (range, 4-12), with no device-related adverse events (AEs). According to the NCI-CTCAE v5.0 scale, 76% (19 of 25) of patients presented grade 0 or 1 mucositis (no ulcers), five patients (20%) developed small ulcers (grade 2), and only one patient developed grade 4 mucositis. Satisfaction rates were high among patients and users.

Conclusion: Photobiomodulation provides excellent safety and tolerance, as well as promising efficacy, both as a preventive and curative strategy, in patients undergoing autologous HCT.

Keywords: HCT; Hematological malignancies; Oral mucositis; Photobiomodulation.

MeSH terms

  • Female
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Male
  • Melphalan / adverse effects
  • Middle Aged
  • Mucositis* / chemically induced
  • Retrospective Studies
  • Stomatitis* / etiology
  • Stomatitis* / pathology
  • Stomatitis* / prevention & control
  • Transplantation Conditioning / adverse effects
  • Transplantation, Autologous

Substances

  • Melphalan