Memorial Sloan-Kettering Cancer Center (MSKCC) researchers showed that cryotherapy given at the time of high-dose melphalan reduced the incidence of severe oral mucositis and the need for pain medicine in patients with multiple myeloma who are undergoing autologous stem cell support. In 2011, MSKCC adopted the use of ice chips given for 30 minutes before, during, and after melphalan ≥140 mg/m2. The retrospective analysis from the pharmacy database sought to determine if this practice reduced the incidence of oral mucositis.
Eighty-five patients who received cryotherapy were compared with 129 similar patients who did not. Investigators found that mucositis (all grades) occurred in 34% who received cryotherapy and 47% who did not (P = .08). Grade 3 and 4 mucositis occurred in 2% and 16%, respectively
(P = .004), and grade 4 mucositis was not observed at all in the cryotherapy group. Cryotherapy was also associated with less use of patient-controlled analgesia (19% vs 37%; P = .01). The authors suggested that because cryotherapy is readily available, it should be offered to all patients receiving high-dose melphalan.
Rodriguez M, Adel NG, Devlin S, et al. Cryotherapy reduces mucositis in multiple myeloma patients receiving high-dose melphalan conditioning prior to autologous stem cell transplantation. Presented at: 54th American Society of Hematology Annual Meeting; December 8-11, 2012; Atlanta, GA. Abstract 4265.