Preventive Versus Curative Photobiomodulation for Oral Mucositis in Patients with Multiple Myeloma Undergoing Hematopoietic Stem Cell Transplantation: Which Approach is More Effective?

Overview

Journal Support Care Cancer

Specialties Critical Care
Oncology

Date 2024 Mar 4

PMID 38438625

Authors

Katia Rupel

Arianna Cornacchia

Monica Poiani

Sara Mohamed

Eleonora De Bellis

Mario Ballerini

Theodora Magdalena Bogdan Preda

Augusto Poropat

Roberto Di Lenarda

Francesco Zaja

Matteo Biasotto

Giulia Ottaviani

Affiliations

Soon will be listed here.

Abstract

Purpose: There is increasing evidence that photobiomodulation (PBM) therapy is both an effective and safe approach in hematopoietic stem cell transplantation (HSCT) for both prevention and management of oral mucositis (OM), but its use in clinical practice is still limited and the timing of application is under discussion. The aim of this retrospective study was to evaluate possible differences between patients treated either with preventive or curative PBM therapy.

Methods: The retrospective case series included 24 patients suffering from multiple myeloma who underwent the same conditioning and transplantation protocol. Patients were treated either with preventive PBM starting from the first day of conditioning up to two days post-HSCT or with curative PBM (starting at OM onset for four consecutive days). OM score, pain, and functional parameters were recorded.

Results: All patients developed OM. Preventive PBM was significantly more effective in reducing OM severity (p < 0.0001) and pain (p < 0.0001) post-HSCT than curative PBM. Furthermore, we found a lower number of patients reporting discomfort in all subjective parameters (pain during swallowing, chewing, and speaking) in the preventive PBM group. No adverse events related to PBM therapy were recorded in both groups.

Conclusion: The timing for PBM therapy in patients undergoing HSCT is crucial: when started on the first day of conditioning, it significantly reduces both pain and OM severity, providing an important benefit also in subjective oral functions such as speaking, swallowing, and chewing, thus increasing the overall adherence to the oncological therapies.

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