Duration of ulcerative mucositis and outcomes of autologous (AU) hematopoietic stem cell transplantation (HSCT) following high-dose melphalan (MP) conditioning for multiple myeloma (MM)

Background: OM is a common toxicity of conditioning regimens for HSCT that has been associated with adverse clinical and economic outcomes. Methods: A retrospective study of approximately 400 consecutive HSCT recipients was undertaken at a single academic center. Data were collected via chart review on days with ulcerative mucositis and selected outcomes including days with fever, days of parenteral narcotic therapy, incidence of Grade III or IV (Common Toxicity Criteria) infection, total inpatient days (LOS), and total inpatient charges. Data are reported here for the 115 MM patients who underwent AU HSCT after high-dose MP conditioning. Results: Mean age of study subjects was 54 years. Seventeen percent of patients received total body irradiation. Bone marrow was the source of most grafts. The relationship between duration of ulcerative mucositis and the outcomes of interest is reported below. Conclusions: Duration of ulcerative OM is associated with worse clinical and economic outcomes in MM patients undergoing AU HSCT following high-dose MP conditioning (Table1) .Table 1Outcomes of AU HSCT Following High-Dose Conditioning for MM, by Days with Ulcerative MucositisDays with Ulcerative Mucositis (Quartile)IIIIIIIVOutcomesn = 32n = 33n = 25n = 25P-value⁎Test for linear trend; Cochran-Armitage for dichotomous and GLM for continuous measures.Fever days (mean,SD)1.0 (1.9)1.9 (3.2)2.5 (2.5)3.1 (3.7).0058Narcotic therapy days (mean,SD)0.7 (1.7)3.9 (3.5)4.4 (3.5)8.8 (5.2)