Selenium May Alleviate Oral Mucositis Associated with High-Dose Chemotherapy and Hematopoietic Stem Cell Transplantation

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(ChemotherapyAdvisor) – Selenium supplements might reduce the severity and duration of oral mucositis (OM) among patients undergoing high-dose chemotherapy and hematopoietic stem cell transplantation (HSCT) for leukemia, report authors of a randomized, double-blind, placebo-controlled study published online in the journal Bone Marrow Transplantation.

Selenium supplementation during high-dose chemotherapy “could prevent severe OM in patients undergoing allogenic HSCT,” concluded lead author Z. Jahangard-Rafsanjani, PharmD, of the Tehran University of Medical Sciences in Iran, and coauthors.

“Selenium has a cytoprotective role via the glutathione peroxidase (Glu.Px) enzyme and prevents chemotherapy-induced toxicities,” the authors reported, suggesting its potential prophylactic value against OM in HSCT patients. Their study included 77 patients who underwent high-dose chemotherapy and HSCT for leukemia; 37 patients were randomly assigned to receive oral selenium tablets (0.2 mg twice daily) from the first day of high-dose chemotherapy until 14 days after HSCT.

Oral mucositis was assessed every day for 21 days after HSCT using the World Health Organization (WHO) oral toxicity scale.

“The incidence of severe OM (grades 3-4) was significantly lower in the selenium group (10.8% vs 35.1%, P<0.05),” the authors reported. “We noted that the duration of objective OM (grades 2-4), excluding patient's self-declaration (grade 1), was significantly shorter in the selenium group (3.6± 1.84 vs .5.3 ± 2.2 days; P=0.014). Significant elevations in serum selenium level and plasma Glu.Px activity were observed 7 and 14 days after transplantation compared with baseline in the selenium group.”

The study was the “first experience of selenium administration in the HSCT setting,” the authors noted. Additional randomized, controlled trials should be undertaken to identify optimal dose and duration of selenium administration, and the long-term outcomes associated with its use, they wrote.


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