ABSTRACT
BACKGROUND: Oral mucositis is a frequent problem after high-dose methotrexate (HD-MTX), impairing patient's quality of life, leading to higher rates of infections and delaying subsequent chemotherapy. This report describes the effect of palifermin in patients treated within the GMALL-B-ALL 2002 protocol containing HD-MTX who developed a severe mucositis in cycle A1/B1. PATIENTS AND METHODS: Ten patients, all with World Health Organization grades III-IV oral mucositis in cycles A1/B1, obtained palifermin with subsequent similar or identical cycles to reduce mucositis. Thus, patients serve as their own control for efficacy of palifermin. RESULTS: All 10 patients developed grades III-IV mucositis in cycles A1/B1 without palifermin, whereas only two of 10 developed grades III-IV mucositis in corresponding cycles A2/B2 with palifermin. Only four of 10 patients showed infections in the cycles with palifermin compared with 10 of 10 patients without palifermin. The duration of mucositits in patients who acquired a higher grade mucositis despite treatment with palifermin could be reduced from 12.9 days (median) without to 11 days with palifermin. The amount of i.v. opioid analgetics could be significantly reduced. CONCLUSION: Palifermin might reduce the incidence, severeness and duration of oral mucositis in HD-MTX-based chemotherapy and may influence clinical sequelae such as infection and quality of life.
Subject(s)
Fibroblast Growth Factor 7/administration & dosage , Methotrexate/adverse effects , Stomatitis/chemically induced , Stomatitis/prevention & control , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Lymphoma, B-Cell/diagnosis , Lymphoma, B-Cell/drug therapy , Male , Methotrexate/administration & dosage , Middle Aged , Pain Measurement , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology , Reference Values , Retrospective Studies , Risk Assessment , Severity of Illness Index , Statistics, Nonparametric , Stomatitis/physiopathology , Treatment OutcomeABSTRACT
Cells of Chenopodium album and whole plants of the duckweed Wolffia arrhiza were cocultivated. In the presence of Wolffia arrhiza the synthesis of a red-violet pigment (betacyanin) was induced in several cells or cell clusters of Chenopodium album in the light. The exchange of solutes through the liquid phase was necessary for the induction of pigment formation. The red-violet cells could be selected and subcultivated resulting in a red callus. A reddish cell suspension was obtained in liquid culture in the presence of the duckweeds.
