Mucositis in the treatment of haematologic malignancies

Background. Mucositis is a highly significant and sometimes dose-limiting complication of many treatments given for blood-related neoplasia, representing a potential source of life-threatening infection and a major driver of total parenteral nutrition use, analgesic therapy, additional nursing care and longer hospitalisation. Aim and Methods. This review was based on a review of the most recent literature and on authors’ experiences, a summary of the current knowledge on mucositis has been provided together with the accepted recommendations on its management. Results. The incidence and severity of mucositis are influenced by patient and treatment variables, being particularly high in the setting of high dose chemotherapy and haematopoietic stem cell transplantation. A five-stage model has been identified in the pathophysiological process of mucositis. Although some interventions have been shown to be potentially effective, in many cases the reported clinical trials and the available data are inadequate to support the recommendation of the majority of agents. Thus, the only proven measures in the prevention of mucositis are cryotherapy and palifermin. Conclusions and perspectives. Further intensive research is necessary, through well-structured clinical trials, in order to obtain the best scientific evidence for agents to prevent and/or treat mucositis in the setting of haematological malignancies.