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Published on: December 8, 2023
Palifermin in children undergoing autologous stem cell transplantation: a matched-pair analysis
Krzysztof Czyzewski1, Robert Debski1, Anna Krenska1
1Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
Insights
Palifermin effectively reduces severe oral mucositis and hospitalization in children undergoing autologous hematopoietic stem cell transplantation (HSCT). This keratinocyte growth factor improves outcomes for pediatric patients, decreasing mucositis duration and infection rates.
Area of Science:
- Hematology
- Oncology
- Pediatric Medicine
Background:
- Keratinocyte growth factor (palifermin) is established for mucositis prevention in adult HSCT recipients.
- Palifermin reduces hospital stay, parenteral nutrition, and opioid use in adults.
- Limited data exist on palifermin's efficacy in pediatric autologous HSCT.
Purpose of the Study:
- To evaluate the efficacy and safety of palifermin in children undergoing autologous HSCT.
- To analyze palifermin's impact on oral mucositis incidence and severity in pediatric patients.
Main Methods:
- Matched-pair analysis of 62 pediatric patients undergoing first autologous HSCT.
- Study group (n=31) received palifermin compassionately; control group (n=31) did not.
- Outcomes assessed included mucositis grade, hospitalization length, and infection rates.
Main Results:
- Palifermin significantly decreased severe (grade 3-4 WHO) oral mucositis (p=0.041).
- Reduced hospitalization length (p=0.047) and shorter oral mucositis duration (p=0.035) were observed.
- Lower incidence of documented infections (p=0.038) was noted; no differences in opioid use, recovery, or TPN.
Conclusions:
- Palifermin is effective in reducing the incidence and severity of oral mucositis in children undergoing autologous HSCT.
- Palifermin demonstrates a favorable safety profile in this pediatric population.
Background:
Keratinocyte growth factor (palifermin) is used for prevention of mucositis in adults following autologous and allogeneic hematopoietic stem cell transplantation (HSCT). It is known that palifermin decreases length of initial hospital stay, mean number of days of total parenteral nutrition (TPN) and the use of opioids for pain control in oral mucositis in adults. There are limited data evaluating palifermin use in children following autologous HSCT.
Aim:
The objective of the present study was the analysis of efficacy and safety of palifermin in children undergoing auto-HSCT.
Patients And Methods:
This matched-pair analysis study included 62 pediatric patients undergoing first auto-HSCT receiving palifermin on a compassionate-use basis (study group, n=31) or not (control group, n=31).
Results:
Palifermin decreased the incidence of severe (grade 3-4 WHO) oral mucositis (p=0.041), length of hospitalization (p=0.047) and contributed to the shorter duration of oral mucositis (p=0.035) and lower incidence of clinically or microbiologically documented infections (p=0.038). There were no differences between groups in opioid use, neutrophil and platelet recovery, TPN use and gastrointestinal hemorrhage.
Conclusion:
Palifermin decreases the incidence and severity of oral mucositis in children undergoing autologous HSCT.
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