Oral cryotherapy for the prevention of high-dose melphalan-induced stomatitis in allogeneic hematopoietic stem cell transplant recipients

Support Care Cancer. 2005 Apr;13(4):266-9. doi: 10.1007/s00520-004-0726-y. Epub 2005 Jan 25.


Goals: The purpose of this study was to evaluate the efficacy of oral cryotherapy to prevent high-dose melphalan-induced stomatitis.

Patients and methods: Eighteen consecutive recipients of allogeneic hematopoietic stem cell transplant conditioned with high-dose melphalan (140 mg/m2) in combination with fludarabine alone or with fludarabine and additional chemotherapy or radiation were enrolled. The severity of stomatitis was graded according to the National Cancer Institute Common Toxicity Criteria. Patients were kept on oral cryotherapy using ice chips and ice-cold water shortly before, during, and for additional 90 min after completion of melphalan administration.

Results: Only two of 18 patients (11.1%) developed grade 2 or 3 stomatitis while six of seven patients in the historical control developed it (85.7%; P=0.001).

Conclusion: These results suggested that oral cryotherapy could effectively prevent stomatitis caused by high-dose melphalan, and we recommend that it should be incorporated into the conditioning regimen with high-dose melphalan.

Publication types

  • Comparative Study

MeSH terms

  • Antineoplastic Agents, Alkylating / administration & dosage
  • Antineoplastic Agents, Alkylating / adverse effects*
  • Cryotherapy*
  • Dose-Response Relationship, Drug
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Japan
  • Male
  • Melphalan / administration & dosage
  • Melphalan / adverse effects*
  • Middle Aged
  • Stomatitis / chemically induced*
  • Stomatitis / prevention & control*


  • Antineoplastic Agents, Alkylating
  • Melphalan