Contributions
Abstract: EP1280
Type: E-Poster Presentation
Session title: Stem cell transplantation - Clinical
Background
Hematopoietic stem cell transplantation (HSCT) that is currently the standard treatment for many hematological diseases is associated with high risk of mucositis. Recent studies showed that vitamins A, C and E play critical role in enhancing immune function and their low concentration in serum can be associated with higher frequency of mucositis and poor outcomes in patients with infectious complications. Relationship between antioxidative vitamines concentration and their inhibitory effect on the expression of proinflammatory cytokines were also described.
Aims
The aim of the study was to analyze the relationship between concentration of vitamins A, C and E and cytokines and the frequency and severity of mucositis in patients with hematological malignancies undergoing autologous HSCT (AHSCT).
Methods
The study group consisted of 57 patients aged 18-70 years (52.3 ± 13.4 years) who underwent high dose therapy (HDT) and HSCT. Eleven patients were diagnosed with Hodgkin's lymphoma (HL), 15 with non-Hodgkin lymphoma (NHL), 30 patients with MM (multiple myeloma) and 1 patient with amyloidosis. The severity of mucositis was assessed according to CTCAE v5.0. Serum concentrations of cytokines (IFN-gamma, IL-3, IL-6, IL-10, IL-1β) and vitamins A, C, E were evaluated before HDT/AHSCT and at the time of hematopoietic recovery (10 - 38 days after HDT/AHSCT) using the traditional ELISA method. A commercial was used according to the manufacturer's instructions.
Results
Mucositis was diagnosed in 26 patients, including eleven patients with grade 1, four with grade 2, six with grade 3, and five with grade 4 according to CTCAE v5.0. Frequency of mucositis was higher in the patients with lymphoma than in the MM patients (17 vs. 9 cases; 29.8% vs. 15.8%). The concentration of vitamin C and E was significantly lower (p < 0.05) after HDT/AHSCT comparing to the pretreatment values in the whole studied group(14748.4±9262.5 vs. 9875.1±8072.6 and 50.9±524.5 vs. 44.6±20.1, respectively).
There was no correlation between the frequency and severity of mucositis and the concentration of vitamin A, C and E before transplantation (p>0.05). After AHSCT concentration of vitamin C was significantly lower (7664.7±6919.5 vs. 12196.1±8701.8) and concentration of vitamin A was significantly higher (0.0025±0.0033 vs. 0.0040±0.0035) in patients with mucositis than in patients without mucositis. Pretreatment concentration of IL-3, IL1β, IL-6 were significant lower in the group of patients with mucositis after HDT/AHSCT : 15.4±45.8 vs. 24.1±65.3, 0.37±0.48 vs. 0.60±0.60 and 5.6±8.6 vs. 6.8±4.9, respectively. There was a positive correlation between the concentration of vitamin A and IL-3 and between the concentration of vitamin C and IL-3, IL-6, IL1β (p<0.05) before AHSCT (p>0.05).
Conclusion
Assessment concentrations of cytokines and antioxidative vitamin may allow to determine the factors predisposing to mucositis after HDT/AHSCT. Supplementation of antioxidative vitamins could be also beneficial to the recovery of the immune system in these patients, but further studies are necessary for a larger group of patients and assessing a larger number of parameters.
Keyword(s): Antioxidants, Cytokine, Mucositis
Abstract: EP1280
Type: E-Poster Presentation
Session title: Stem cell transplantation - Clinical
Background
Hematopoietic stem cell transplantation (HSCT) that is currently the standard treatment for many hematological diseases is associated with high risk of mucositis. Recent studies showed that vitamins A, C and E play critical role in enhancing immune function and their low concentration in serum can be associated with higher frequency of mucositis and poor outcomes in patients with infectious complications. Relationship between antioxidative vitamines concentration and their inhibitory effect on the expression of proinflammatory cytokines were also described.
Aims
The aim of the study was to analyze the relationship between concentration of vitamins A, C and E and cytokines and the frequency and severity of mucositis in patients with hematological malignancies undergoing autologous HSCT (AHSCT).
Methods
The study group consisted of 57 patients aged 18-70 years (52.3 ± 13.4 years) who underwent high dose therapy (HDT) and HSCT. Eleven patients were diagnosed with Hodgkin's lymphoma (HL), 15 with non-Hodgkin lymphoma (NHL), 30 patients with MM (multiple myeloma) and 1 patient with amyloidosis. The severity of mucositis was assessed according to CTCAE v5.0. Serum concentrations of cytokines (IFN-gamma, IL-3, IL-6, IL-10, IL-1β) and vitamins A, C, E were evaluated before HDT/AHSCT and at the time of hematopoietic recovery (10 - 38 days after HDT/AHSCT) using the traditional ELISA method. A commercial was used according to the manufacturer's instructions.
Results
Mucositis was diagnosed in 26 patients, including eleven patients with grade 1, four with grade 2, six with grade 3, and five with grade 4 according to CTCAE v5.0. Frequency of mucositis was higher in the patients with lymphoma than in the MM patients (17 vs. 9 cases; 29.8% vs. 15.8%). The concentration of vitamin C and E was significantly lower (p < 0.05) after HDT/AHSCT comparing to the pretreatment values in the whole studied group(14748.4±9262.5 vs. 9875.1±8072.6 and 50.9±524.5 vs. 44.6±20.1, respectively).
There was no correlation between the frequency and severity of mucositis and the concentration of vitamin A, C and E before transplantation (p>0.05). After AHSCT concentration of vitamin C was significantly lower (7664.7±6919.5 vs. 12196.1±8701.8) and concentration of vitamin A was significantly higher (0.0025±0.0033 vs. 0.0040±0.0035) in patients with mucositis than in patients without mucositis. Pretreatment concentration of IL-3, IL1β, IL-6 were significant lower in the group of patients with mucositis after HDT/AHSCT : 15.4±45.8 vs. 24.1±65.3, 0.37±0.48 vs. 0.60±0.60 and 5.6±8.6 vs. 6.8±4.9, respectively. There was a positive correlation between the concentration of vitamin A and IL-3 and between the concentration of vitamin C and IL-3, IL-6, IL1β (p<0.05) before AHSCT (p>0.05).
Conclusion
Assessment concentrations of cytokines and antioxidative vitamin may allow to determine the factors predisposing to mucositis after HDT/AHSCT. Supplementation of antioxidative vitamins could be also beneficial to the recovery of the immune system in these patients, but further studies are necessary for a larger group of patients and assessing a larger number of parameters.
Keyword(s): Antioxidants, Cytokine, Mucositis