Prophylactic Effect of Polaprezinc, a Zinc-L-carnosine, Against Chemotherapy-induced Oral Mucositis in Pediatric Patients Undergoing Autologous Stem Cell Transplantation

• Published in: Anticancer research Vol. 38; no. 8; pp. 4691 - 4697
• Main Authors: Funato, Miyui, Ozeki, Michio, Suzuki, Akio, Ishihara, Masashi, Kobayashi, Ryo, Nozawa, Akifumi, Yasue, Shiho, Endo-Ohnishi, Saori, Fukao, Toshiyuki, Itoh, Yoshinori
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.08.2018
• Subjects: Adolescent; Alginic acid; Analgesics; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Autografts; Azulene; Carnosine; Carnosine - analogs & derivatives; Carnosine - therapeutic use; Chemotherapy; Child; Child, Preschool; Children; Comparative studies; Female; Hematologic Neoplasms - drug therapy; Hematology; Hematopoietic Stem Cell Transplantation - methods; Hematopoietic stem cells; Humans; Incidence; Infant; Male; Medical records; Mucositis; Mucous membrane; Nutrition; Opioids; Organometallic Compounds - therapeutic use; Parenteral nutrition; Patients; Pediatrics; Radiation therapy; Retrospective Studies; Sodium; Sodium alginate; Stem cell transplantation; Stem cells; Stomatitis - chemically induced; Stomatitis - drug therapy; Transplantation; Transplantation, Autologous - methods; Zinc; Zinc - therapeutic use; Zinc Compounds - therapeutic use; hematopoietic stem cell transplantation; polaprezinc; Oral mucositis; chemotherapy
• ISSN: 0250-7005; 1791-7530
• DOI: 10.21873/anticanres.12775

Polaprezinc suspension in sodium alginate (PZ-AG) reduces the incidence and severity of oral mucositis in adult patients receiving radiotherapy or high-dose chemotherapy. In the present study, the prophylactic effect of PZ-AG against oral mucositis was assessed in pediatric patients with hematological malignancies receiving high-dose chemotherapy followed by hematopoietic stem cell transplantation (HSCT). Data of 16 children who underwent HSCT during a period between January 2010 and December 2017 were obtained from medical records and they were retrospectively analyzed. Oral mucositis was evaluated by the WHO scale. Six (37.5%) of 16 children refused to take PZ-AG in a preliminary assessment and they were pretreated with azulene gargle. The remaining 10 (62.5%) patients were pretreated with PZ-AG for prevention of oral mucositis. Grade≥ 3 oral mucositis occurred in 5 (83.3%) of 6 patients receiving azulene gargle, but in 2 (20%) patients who took PZ-AG (p=0.035). The prevalence for the use of opioid analgesics was also significantly lower (30% vs. 100%, p=0.011), while the average duration of total parenteral nutrition use was significantly shorter (11.1 days vs. 24.3 days, p=0.016), in PZ-AG group than in azulene group. On the other hand, PZ-AG had no significant influence on the incidence of other adverse events, mean time to engraftment, or overall survival. PZ-AG was found to be highly effective in preventing oral mucositis in pediatric patients with hematological malignancies receiving high-dose chemotherapy followed by HSCT, as in adult patients.