Incidence and severity of oral mucositis in patients undergoing haematopoietic SCT--results of a multicentre study.

Oral mucositis (OM) is a common side effect experienced during haematopoietic SCT (HSCT), and it can have a significant impact on the quality of life of patients. A descriptive nurse-led study was undertaken in 19-member centres of the Italian national transplant group (GITMO) evaluating incidence, severity and duration of OM in patients undergoing HSCT. Data from 1841 patients between 2002 and 2006 was analyzed. Initial medical history and oral cavity assessment was performed. Assessment was repeated on the day of transplant, then daily, using the WHO (World Health Organisation) oral toxicity scale. A total of 71% of the patients evaluated developed mucositis and 21.6% developed severe mucositis. Duration of OM in most cases lasted for 10-14 days and resolved along with marrow reconstitution. Oral mucostitis is a frequent side effect in patients undergoing HSCT. The onset of severe mucositis seems to be related to the conditioning regimen used. This database provides a descriptive overview of the incidence and severity of mucositis and has encouraged participating centres to adopt routine evaluation and measurement of the oral cavity. The assessment tools are still used in some centres, providing a basis for further collaborative research projects.

The central venous catheter in a bone marrow transplant unit: an unresolved problem.

Bone marrow transplantation (BMT) is feasible with a bearable risk and discomfort for patients only if good venous access is provided. Therefore a major task for nurses of a BMT unit is management of a patient's central venous catheter. There is not general agreement about the procedure of handling a CVC and infection prophylaxis. We collected data from some Italian BMT and hematology units by means of a questionnaire. The responses to this questionnaire were not comparable except for some particulars. Each center has its own ritual procedure; even the use of sterile gloves while handling the most dangerous connections of the catheter is not the rule everywhere. It is noteworthy that only a minority of physicians are able to handle a catheter correctly.