Protective effect of cryotherapy against oral mucositis among allogeneic hematopoietic stem cell transplant recipients using melphalan-based conditioning.

PURPOSE: Oral cryotherapy is an effective method to prevent oral mucositis (OM) induced by chemotherapeutic agents, such as melphalan (Mel). However, there is limited data about cryotherapy in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients; thus, the current study aimed to examine the efficacy of cryotherapy among allo-HSCT recipients treated with Mel-containing regimens. METHODS: Medical records of 78 consecutive allo-HSCT recipients were retrospectively analyzed. Baseline characteristics and clinical courses between the patients who received cryotherapy (cryotherapy group, n = 42) and those who did not (control group, n = 36) were compared, especially focusing on methotrexate (MTX) use as a part of graft-versus-host disease (GVHD) prophylaxis. RESULTS: Binary logistic regression analysis revealed that a higher dose of Mel (OR, 3.82; 95%CI, 1.085-13.46; P = 0.037) or MTX use (OR, 7.61; 95% CI, 2.41-23.97; P < 0.001) was associated with the incidence of OM. MTX use was also significantly associated with the duration of OM (ß = 0.515; 95% CI, 9.712-21.636; P < 0.001). Among 31 patients without MTX use, cryotherapy was associated with a significant reduction of OM development (0% in the cryotherapy group vs 35% in the control group, P = 0.021). We did not find such an association in 47 patients with MTX use. CONCLUSION: Cryotherapy was useful to prevent the incidence of OM in allo-HSCT recipients in the cases without MTX for GVHD prophylaxis.

Effect of Dietary Protein Levels on Protein Nutritional Status in Growing Female Rats Kept under Constant Darkness.

The purpose of this study was to clarify the effects of dietary protein levels on protein nutritional status in rats kept under constant darkness. Thirty-six 4-wk-old female rats (F344 strain) were divided into six groups. Each group was given a diet with one of three different protein levels and kept under normal light and dark cycles (7:00-19:00 light period/19:00-7:00 dark period, N group) or under constant darkness (D group) for 4 wk. The protein levels of the diets were 10%, 20%, and 30% casein. The six groups are referred to as the N10%, N20%, N30%, D10%, D20%, and D30% groups. Body weight gain was low in the D groups, and that in the D30% group was much lower than that in the N30% group. The D30% group retained less nitrogen than the N30% group. As for the amount of urinary nitrogen excreted every 4 h, the values for the D-groups were higher than those for the N-groups in the 11:00-15:00 periods, and that for the D30% group was higher than that for the N30% group in the 15:00-19:00 periods, which means that protein catabolism was higher in the D30% group. It was shown that when rats kept under constant darkness were fed a high-protein diet for 4 wk, their nitrogen retention decreased and their protein nutritional state dropped.