ORIGINAL ARTICLE Self-reported experience of mucositis in cancer patients who underwent conditioning regimen and stem cell transplantation Mustafa Ozturk & Seref Komurcu & Selim Kilic & Ahmet Ozet & Fikret Arpaci & Bekir Ozturk & Okan Kuzhan & Selmin Ataergin Received: 31 July 2008 / Accepted: 19 January 2009 / Published online: 6 February 2009 # Springer-Verlag 2009 Abstract Purpose This study was done to evaluate the frequency and severity of mucositis in the early period of stem cell transplantation (SCT) and the relation of conditioning regimens with mucositis. Patients and methods Patients with hematologic or solid tumors who underwent conditioning regimen were asked to score mucositis severity daily from the first day to the tenth day of reinfusion. Patient-reported scoring was performed according to a five-grade scale (0: no symptom; 1: mild; 2: moderate; 3: severe; 4: very severe). Total mucositis score (TMS) was defined as the addition of daily mucositis scores for 10 days. A total of 68 SCT (58 autologous and 10 allogeneic) patients, 48 men (71%) and 20 women (29%) were included to the study. Median age of patients was 32.5 (range 15–78) years. The most frequent three diagnosis were non-Hodgkin’ s lymphoma (37%, n =25), Hodgkin’ s lymphoma (12%, n =8), and multiple myeloma (12%, n =8). BEAM (n = 27), ICE (n =17), melphelan 200 mg/m 2 (M200) (n =8), and TBI+C (total body irradiation + cyclophospha- mide) (n =16) were used as conditioning regimens. Results All of the patients experienced mucositis at any grade. TMS in the sixth day was higher than TMS in the first day (p <0.05). TMS was not related to the diagnosis or gender (p >0.05). TMS at ICE regimen in the first 5 days after transplantation was more severe than BEAM regimen. TMS at TBI+C regimen was higher than TMS at BEAM regimen from day 4 to day 10 (p <0.05). The mean percentages of patients who scored severe or very severe mucositis in 10 days was 7.4% in BEAM, 8.9% in ICE, 12.5% in M200, and 31.2% in TBI+C groups. Conclusion Patients experience mucositis frequently follow- ing conditioning regimen and SCT. The necessity and the timing of prophylaxis for mucositis change due to the type of conditioning regimens. Keywords Mucositis . Stem cell transplantation . Conditioning regimen . TBI+C . BEAM . ICE Introduction Oral mucositis prevalence ranges from 75% to 85% in patients who underwent conditioning regimen and SCT, and mucositis is reported as one of the most debilitating side effects [1]. Mucositis is presented with erythema, ulceration, bleeding, and edema along with pain and is described as the clinical manifestation of damage to gastrointestinal epithelium caused by chemotherapeutics or radiation injury. The pathogenesis of mucositis depends on the damage to the epithelium and underlying tissue [11]. The main pathologic changes are increased vascular permeability, edema, inflammatory cell infiltration, and fibrosis, which induce salivary gland damage and loss of saliva barrier function. Usually cell regeneration cannot keep up with cell killing and denudation develops. On the other side, conditioning regimen provokes myelosupression that leads to mucosal superinfection. Mucositis negatively affects other health outcomes as well, increasing the risk of opportunistic infections and mortality due to sepsis [13]. Support Care Cancer (2009) 17:1295–1299 DOI 10.1007/s00520-009-0586-6 M. Ozturk (*) : S. Komurcu : A. Ozet : F. Arpaci : B. Ozturk : O. Kuzhan : S. Ataergin Department of Medical Oncology, Gulhane Medical Academy, Ankara, Turkey e-mail: drmustafaozturk@yahoo.com S. Kilic Department of Public Health, Gulhane Medical Academy, Ankara, Turkey