Longitudinal Multicompartment Oral Mucositis Assessment in Adults Undergoing Myeloablative Allogeneic Hematopoietic...

Oral mucositis (OM) is a frequent, debilitating complication of myeloablative allogeneic hematopoietic cell transplantation (HCT). OM grading tools used in HCT practice rely on subjective or summary scoring, potentially missing clinically important details. To test the performance of the oral mucositis assessment scale (OMAS), a validated comprehensive OM assessment tool that collects granular objective findings from 7 intraoral sites, in a contemporary cohort. We longitudinally evaluated site-specific OM characteristics using OMAS in 47 myeloablative allogeneic HCT recipients. A total of 249 assessments were completed at baseline (preconditioning) and on d +7, +14, +21, +28, and +84 post-transplant. Total and site-specific scores strongly correlated with patient-controlled analgesia use. D +7 involvement of the floor of mouth (P = .013), soft palate (P = .008), and ventrolateral tongue (P = .003) was associated with a greater total mucositis score. OM was overall more severe in men, driven by higher scores on d +7 (P = .013) and in the soft palate (P = .013). Graft-versus-host disease prophylaxis regimens based on post-transplantation cyclophosphamide or methotrexate led to more severe d +14 OM than those based on mycophenolate mofetil (P = .028). In this prospective analysis of myeloablative allogeneic HCTs in a contemporary cohort, OMAS provided clinically relevant, granular, site-specific data not captured by popular summary-based scoring systems. We expect our findings to facilitate the development of effective strategies to prevent and treat OM.