Physical function and symptoms in adult hematopoietic stem cell transplantation patients, by severity of oral mucositis: a prospective study.

Hematopoietic cell transplantation (HCT) is a curative treatment for hematological malignancies that aims to restore hematopoietic function. However, it involves significant toxicities, including oral mucositis. Oral mucositis (OM) impairs nutrition, extends hospital stays, and reduces quality of life. Physical function declines post-transplant, but the role of severe oral mucositis in worsening this impairment remains unclear. To compare the differences in physical function and treatment-related symptoms before and after HCT between adult patients with hematologic cancer who did and did not develop severe oral mucositis during their hospitalization. A prospective longitudinal study was conducted at Clínica Dávila, Santiago, Chile, with 31 adult patients undergoing allogeneic or autologous HCT between September 2023 and March 2024. Patients were grouped based on the presence of severe OM, which was assessed using the WHO scale. Physical function was evaluated with the 30-second sit-to-stand test, handgrip strength, and the 2-minute step test, while treatment-related symptoms intensity was measured using the Edmonton Symptom Assessment Scale. OM incidence was 74.2%, with severe OM affecting 29% of patients. Patients with severe OM scored significantly lower on the sit-to-stand test (Mean Difference 1.5 repetitions, p=0.048); showed higher levels of pain, appetite loss, and nausea; and required more days of parenteral nutrition (p<0.05). OM onset occurred at day 9.3 post-allogeneic HCT and day 13.6 post-autologous HCT, ending at day 17.0 and day 11.3, respectively. Patients who develop severe oral mucositis after undergoing HCT experience greater impairment in lower limb strength, loss of appetite, pain and nausea at discharge than their counterparts.