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Retrospective Evaluation of Palifermin Use in Nonhematopoietic Stem Cell Transplant Pediatric Patients
Dazhi Liu1, Brian Seyboth, Sherry Mathew
1Departments of *Pharmacy Service †Pediatrics ‡Epidemiology and Statistics, Memorial Sloan Kettering, Cancer Center, New York, NY.
Insights
Palifermin effectively prevented severe oral mucositis recurrence in pediatric cancer patients receiving chemotherapy. This study shows palifermin
Area of Science:
- Oncology
- Pharmacology
- Pediatric Medicine
Background:
- Palifermin is a proven treatment for severe oral mucositis in adult cancer patients undergoing chemotherapy.
- The efficacy of palifermin in pediatric patients receiving chemotherapy, particularly in nonhematopoietic stem cell transplantation (HSCT), remains undocumented.
- Oral mucositis significantly impacts pediatric cancer patients' quality of life and treatment outcomes.
Purpose of the Study:
- To evaluate the effectiveness of palifermin as a secondary prophylaxis for chemotherapy-induced oral mucositis in pediatric patients.
- To assess the impact of palifermin on mucositis recurrence, pain management, nutritional support, and hospitalization duration in pediatric cancer patients.
Main Methods:
- Retrospective analysis of 18 pediatric patients treated with palifermin for secondary mucositis prophylaxis at Memorial Sloan Kettering Cancer Center (2008-2014).
- Data collected from electronic medical records included mucositis resolution, opioid use, total parenteral nutrition (TPN) requirements, hospitalization duration, and antibiotic use.
- Patients received palifermin after experiencing mucositis in a prior chemotherapy cycle.
Main Results:
- Palifermin prophylaxis prevented mucositis recurrence in 13 out of 18 pediatric patients during subsequent chemotherapy cycles.
- The majority of patients experienced reduced opioid and antibiotic use, and shorter hospitalizations.
- Six of seven patients previously requiring TPN showed decreased nutritional support needs after palifermin administration.
Conclusions:
- Palifermin demonstrates potential as an effective secondary prophylactic agent against chemotherapy-induced oral mucositis in pediatric cancer patients.
- Further research is warranted to confirm these findings and establish optimal palifermin dosing and administration protocols in pediatric oncology.
Background:
Palifermin has been proven to decrease the frequency of severe oral mucositis in adult patients with sarcoma and metastatic colorectal cancer receiving chemotherapy. The impact of palifermin on the incidence of mucositis in nonhematopoietic stem cell transplantation (HSCT) pediatric population receiving chemotherapy has never been reported to date.
Patients And Methods:
This is a retrospective analysis of pediatric patients who received palifermin as secondary prophylaxis to prevent chemotherapy-induced mucositis at Memorial Sloan Kettering Cancer Center from January 1, 2008 to 2014. Data from electronic medical records on days to mucositis resolution, use of opioids, use of total parenteral nutrition, duration of hospitalization, and antibiotics are collected and presented here.
Results:
A total of 18 patients received palifermin for secondary prophylaxis after developing mucositis from the prior chemotherapy cycle. Mucositis did not reoccur in the subsequent cycle for 13 of the 18 patients. The majority of patients who received palifermin prophylaxis had decreased opioids and antibiotics use and decreased duration of hospitalization. Six of the 7 patients previously requiring total parenteral nutrition due to mucositis had decreased supplemental nutritional needs following the use of palifermin.
Conclusion:
Palifermin may provide benefit as secondary prophylaxis in pediatric patients to prevent chemotherapy-induced mucositis.
