Impact of cryotherapy on incidence and severity of oral mucositis in hematopoietic stem cell transplantation: retrospective observational study

Abstract

Abstract Oral mucositis (OM) is a common and significant complication of chemotherapy and radiotherapy, particularly in patients undergoing hematopoietic stem cell transplantation (HSCT). This retrospective observational study assessed the effectiveness of oral cryotherapy in reducing the incidence and severity of OM in 258 HSCT recipients treated at a single transplant center in Poland between 2018 and 2024. Patients were divided into two groups: 199 received cryotherapy as part of their conditioning regimen, while 59 did not. Cryotherapy was administered using ice chips from 10 min before chemotherapy infusion to two hours afterward. OM occurred in 48% of the cryotherapy group versus 68% in the control group, representing a statistically significant 20% relative risk reduction ( p  = 0.008). Furthermore, the incidence of severe OM (grades 3–4) was significantly lower in the cryotherapy group ( p  = 0.006). No significant differences were observed in platelet engraftment or hospitalization duration. Although neutrophil engraftment was slightly delayed in the cryotherapy group, this finding lacked clinical relevance. Overall, the results support cryotherapy as a safe, cost-effective, and easily implementable strategy for OM prevention in the HSCT setting. Further prospective studies are warranted to validate these findings and optimize treatment protocols.