Efficacy of palifermin in the treatment of oral mucositis in non-hematopoietic stem cell transplant pediatric patients: experience of a single tertiary hospital

Abstract Background Severe oral mucositis (OM) is one of the adverse events post-chemotherapy, radiation, and stem cell transplantation with major clinical and economic impact. The management of severe OM remains challenging. This study aimed to look for the benefit and clinical impact of palifermin...

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Main Authors: Hasna Hamzi, Amal Binhassan, Amal Najmeldin, Ebtsam Alhariri, Bodour Elhussein, Nour Althibani, Ahmad Alenazi, Shahad Alsharif, Mohammad Alshahrani, Omar Alsharif, Nawaf Alkhayat, Yasser Elborai
Format: Article
Language:English
Published: SpringerOpen 2024-12-01
Series:Journal of the Egyptian National Cancer Institute
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Online Access:https://doi.org/10.1186/s43046-024-00247-x
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author Hasna Hamzi
Amal Binhassan
Amal Najmeldin
Ebtsam Alhariri
Bodour Elhussein
Nour Althibani
Ahmad Alenazi
Shahad Alsharif
Mohammad Alshahrani
Omar Alsharif
Nawaf Alkhayat
Yasser Elborai
author_facet Hasna Hamzi
Amal Binhassan
Amal Najmeldin
Ebtsam Alhariri
Bodour Elhussein
Nour Althibani
Ahmad Alenazi
Shahad Alsharif
Mohammad Alshahrani
Omar Alsharif
Nawaf Alkhayat
Yasser Elborai
author_sort Hasna Hamzi
collection DOAJ
description Abstract Background Severe oral mucositis (OM) is one of the adverse events post-chemotherapy, radiation, and stem cell transplantation with major clinical and economic impact. The management of severe OM remains challenging. This study aimed to look for the benefit and clinical impact of palifermin for mucositis among the non-transplanted pediatric cancer population. Methods This is a descriptive retrospective study extended from 2016 to 2020 at Prince Sultan Military Medical City (PSMMC), in Saudi Arabia. During this period all pediatric patients (< 14 years of age) on chemotherapy and complicated by severe OM that required palifermin (35 courses), as off-labeled medication, were analyzed looking for the clinical demographics, primary diagnosis, chemotherapy agents used, effectiveness, and tolerability of palifermin. Results A total of 29 patients with severe OM received 35 palifermin courses. All of them received 60 mcg/kg/day IV for 3 consecutive days. 20% of them have acute lymphoblastic leukemia (ALL). We noticed that 60% of severe OM required palifermin post anthracycline while high-dose methotrexate aggravates the risk in 40% of them. Only 25.7% of the patients required TPN for a median duration of 5 days and 54.3% of them received opioids for a median duration of 4 days. Twenty patients (57.1%) had used antibiotics, 4 patients were on antifungal medication and 1 patient was on anti-viral medication concomitant with antibiotics. Conclusion Palifermin is safe and well tolerated and shows some effect in non-hematopoietic stem cell transplant pediatric patients with severe oral mucositis post-intensified chemotherapy or radiation therapy.
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spelling doaj-art-cb4af0d89e3a47b197d2a3b78de2dd932025-08-20T02:30:59ZengSpringerOpenJournal of the Egyptian National Cancer Institute2589-04092024-12-013611510.1186/s43046-024-00247-xEfficacy of palifermin in the treatment of oral mucositis in non-hematopoietic stem cell transplant pediatric patients: experience of a single tertiary hospitalHasna Hamzi0Amal Binhassan1Amal Najmeldin2Ebtsam Alhariri3Bodour Elhussein4Nour Althibani5Ahmad Alenazi6Shahad Alsharif7Mohammad Alshahrani8Omar Alsharif9Nawaf Alkhayat10Yasser Elborai11Department of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityDepartment of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityDepartment of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityDepartment of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityDepartment of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityDepartment of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityDepartment of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityDepartment of Pediatric, Alyamamah HospitalDepartment of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityDepartment of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityDepartment of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityDepartment of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityAbstract Background Severe oral mucositis (OM) is one of the adverse events post-chemotherapy, radiation, and stem cell transplantation with major clinical and economic impact. The management of severe OM remains challenging. This study aimed to look for the benefit and clinical impact of palifermin for mucositis among the non-transplanted pediatric cancer population. Methods This is a descriptive retrospective study extended from 2016 to 2020 at Prince Sultan Military Medical City (PSMMC), in Saudi Arabia. During this period all pediatric patients (< 14 years of age) on chemotherapy and complicated by severe OM that required palifermin (35 courses), as off-labeled medication, were analyzed looking for the clinical demographics, primary diagnosis, chemotherapy agents used, effectiveness, and tolerability of palifermin. Results A total of 29 patients with severe OM received 35 palifermin courses. All of them received 60 mcg/kg/day IV for 3 consecutive days. 20% of them have acute lymphoblastic leukemia (ALL). We noticed that 60% of severe OM required palifermin post anthracycline while high-dose methotrexate aggravates the risk in 40% of them. Only 25.7% of the patients required TPN for a median duration of 5 days and 54.3% of them received opioids for a median duration of 4 days. Twenty patients (57.1%) had used antibiotics, 4 patients were on antifungal medication and 1 patient was on anti-viral medication concomitant with antibiotics. Conclusion Palifermin is safe and well tolerated and shows some effect in non-hematopoietic stem cell transplant pediatric patients with severe oral mucositis post-intensified chemotherapy or radiation therapy.https://doi.org/10.1186/s43046-024-00247-xPaliferminOral mucositisPediatric malignancyHematopoietic stem cell transplant
spellingShingle Hasna Hamzi
Amal Binhassan
Amal Najmeldin
Ebtsam Alhariri
Bodour Elhussein
Nour Althibani
Ahmad Alenazi
Shahad Alsharif
Mohammad Alshahrani
Omar Alsharif
Nawaf Alkhayat
Yasser Elborai
Efficacy of palifermin in the treatment of oral mucositis in non-hematopoietic stem cell transplant pediatric patients: experience of a single tertiary hospital
Journal of the Egyptian National Cancer Institute
Palifermin
Oral mucositis
Pediatric malignancy
Hematopoietic stem cell transplant
title Efficacy of palifermin in the treatment of oral mucositis in non-hematopoietic stem cell transplant pediatric patients: experience of a single tertiary hospital
title_full Efficacy of palifermin in the treatment of oral mucositis in non-hematopoietic stem cell transplant pediatric patients: experience of a single tertiary hospital
title_fullStr Efficacy of palifermin in the treatment of oral mucositis in non-hematopoietic stem cell transplant pediatric patients: experience of a single tertiary hospital
title_full_unstemmed Efficacy of palifermin in the treatment of oral mucositis in non-hematopoietic stem cell transplant pediatric patients: experience of a single tertiary hospital
title_short Efficacy of palifermin in the treatment of oral mucositis in non-hematopoietic stem cell transplant pediatric patients: experience of a single tertiary hospital
title_sort efficacy of palifermin in the treatment of oral mucositis in non hematopoietic stem cell transplant pediatric patients experience of a single tertiary hospital
topic Palifermin
Oral mucositis
Pediatric malignancy
Hematopoietic stem cell transplant
url https://doi.org/10.1186/s43046-024-00247-x
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