Propantheline protects the oral mucosa after high-dose ifosfamide, carboplatin, etoposide and autologous stem cell transplantation

Bone Marrow Transplantation
D J OblonS Malik

Abstract

Oral mucositis is a dose-limiting toxicity of high-dose etoposide regimens. Since etoposide is excreted in saliva, we tested the hypothesis that the induction of xerostomia would reduce the severity of the mucositis. We designed a phase II trial of propantheline in patients receiving high-dose ICE (ifosfamide 20 mg/m2, carboplatin 1.8 g/m2, etoposide 3 g/m2 in divided doses over 6 days) chemotherapy plus autologous hematopoietic stem cell support. We treated 31 consecutive patients and graded the oral mucositis according to WHO criteria. Mild (WHO grade 0, I, II) mucositis occurred in 28 of 31 (90%) (95% CI 74-98%) patients; severe (WHO grade III, IV) mucositis occurred in three of 31 patients (10%) (95% CI 2-25%) patients. In contrast, a published reference group treated with the same doses and schedule of ICE reported mild mucositis in 10 of 46 (22%) (95% CI 11-36%) patients and severe mucositis in 36 of 46 (78%) (95% CI 64-89%). Propantheline therapy had no protective effect on esophagitis and enteritis associated with high-dose ICE. Minor toxicities were constipation and asymptomatic tachycardia; major toxicities were palpitations in one patient and urinary retention in one patient. We conclude that anticholinergic therapy ...Continue Reading

Citations

Aug 1, 2013·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Siri Beier JensenUNKNOWN Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (
Jan 3, 2003·Oral Oncology·Andrei Barasch, Douglas E Peterson
Aug 24, 2002·Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics·Joel B EpsteinJonathan A Ship
Jul 23, 1999·Current Opinion in Oncology·D E Peterson
Feb 7, 2007·Journal of Pediatric Hematology/oncology·Virginie GandemerUNKNOWN Pain task force of the SFCE
Apr 26, 2006·Expert Opinion on Emerging Drugs·Joel B Epstein, Gary D Klasser
May 17, 2006·Oral Diseases·C ScullyP D Diz

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