Tohoku J. Exp. Med., 2006, 210(4)

Prophylaxis of Mucosal Toxicity by Oral Propantheline and Cryotherapy in Children with Malignancies Undergoing Myeloablative Chemo-Radiotherapy

ATSUSHI SATO,¹ TAKAKO SAISHO-HATTORI,² YOSHITSUGU KOIZUMI,² MASAYOSHI MINEGISHI,³ KAZUIE IINUMA² and MASUE IMAIZUMI¹

¹Department of Hematology and Oncology, Miyagi Children's Hospital, Sendai, Japan, ²Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan, ³Division of Blood Transfusion, Tohoku University Hospital, Sendai, Japan

Mucosal toxicity is an incapacitating complication of intensive chemo-radiotherapy for children with malignant disorders, and is physically and psychologically distressful. It is therefore important to minimize mucosal toxicity in those patients. In this report, the effects of the combined prophylaxis of oral cooling (cryotherapy) and administration of propantheline, an anticholinergic drug, were studied in patients (aged 2-16 year) with acute leukemias or solid tumors, who underwent myeloablative chemo-radiotherapy and autologous peripheral blood stem cell rescue from 1993 to 1997. Patients were pretreated with the combined prophylaxis (n = 12) or single prophylaxis (n = 5), or left untreated (n = 7). The combined prophylaxis significantly reduced the severe mucositis (combined, 8.3%; single, 20.0%; and untreated, 42.9%) and severe diarrhea (combined, 16.7%; single, 60.0%; and untreated, 57.1%). Moreover, the combined prophylaxis tended to shorten the periods of febrile episodes defined as temperature > 38°C (combined, 3.8 days; single, 4.6 days; and untreated, 5.6 days). Therefore, the combination of propantheline and oral cryotherapy may be feasible and effective for reduction of mucosal toxicity in patients with malignancy who undergo high-dose chemotherapy.

keywords —— propantheline; cryotherapy; mucosal toxicity; peripheral blood stem cell rescue; myeloablative chemotherapy

© 2006 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2006, 210, 315-320

Correspondence: Dr. Atsushi Sato, Department of Hematology and Oncology, Miyagi Children's Hospital, 4-3-17 Ochiai, Aoba-ku, Sendai 989-3126, Japan.

e-mail: asato@miyagi-children.or.jp