Evidence map›Paper›PMID 40867286›Full record

ReviewCancers2025

Elevated Likelihood of Infectious Complications Related to Oral Mucositis After Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis of Outcomes and Risk Factors.

Susan Eichhorn, Lauryn Rudin, Chidambaram Ramasamy, Ridham Varsani, Parikshit Padhi, Nour Nassour, Kapil Meleveedu, Joel B Epstein, Benjamin Semegran, Roberto Pili and 1 more

Abstract readReview
In one paragraph

Review in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Susan EichhornBoston Medical Center, Boston, MA 02118, USA.
Lauryn RudinJacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA.ORCID 0009-0009-2505-3014
Chidambaram RamasamyCarol and Ray Neag Comprehensive Cancer Center, University of Connecticut Health Center, Farmington, CT 06030, USA.
Ridham VarsaniSchool of Dental Medicine, University at Buffalo, Buffalo, NY 14215, USA.ORCID 0009-0006-0274-7257
Parikshit PadhiKaleida Health Infusion Center, Department of Medicine, Division of Hematology and Oncology, University at Buffalo, Buffalo, NY 14221, USA.ORCID 0000-0001-9888-1595
Nour NassourJacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA.
Kapil MeleveeduCarol and Ray Neag Comprehensive Cancer Center, University of Connecticut Health Center, Farmington, CT 06030, USA.
Joel B EpsteinCity of Hope National Cancer Center, Duarte, CA 91010, USA.
Benjamin SemegranJacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA.
Roberto PiliDepartment of Medicine, Division of Hematology and Oncology, University at Buffalo, Buffalo, NY 14203, USA.
Poolakkad S SatheeshkumarDepartment of Medicine, Division of Hematology and Oncology, University at Buffalo, Buffalo, NY 14203, USA.ORCID 0000-0003-1033-6627

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Mucositis involving the gastrointestinal, vaginal, and nasal mucosa is one of the primary dose-limiting toxicities of hematopoietic stem cell transplantation (HSCT) and its conditioning regimen. The oropharyngeal mucosa is commonly affected, which can be detrimental to patient health and quality of life. Despite its significant prevalence and deleterious effects, we have an inadequate understanding of the risk factors and outcomes associated with oral mucositis (OM). We performed a literature search through PubMed and EBSCO (inception to 31 March 2024) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data was extracted from eligible studies using a pre-specified data extraction form. Quality of the data was assessed using the Newcastle-Ottawa Scale for non-randomized, observational studies and the Cochrane Collaboration Tool for randomized controlled trials. Our initial search identified 1677 articles, 34 of which were included in our study. Of those 34, 30 were included in the qualitative assessment of clinical risk factors in the development of OM, and 4 were included in the meta-analysis assessing the relationship between OM and infectious complications following HSCT. Across both HSCT modalities and cancer cohorts, female sex and high-intensity conditioning were common risk factors in the development of OM. When stratified by allogeneic and autologous HSCT, methotrexate, younger age, and longer duration of neutropenia were associated with increased OM risk in allogeneic HSCT recipients, while renal dysfunction, HSV-1 reactivation, and longer neutrophil engraftment were associated with increased OM risk in autologous HSCT recipients. Longer neutrophil engraftment was a common risk factor across different cancer cohorts; however, renal dysfunction was a distinct risk factor for OM in multiple myeloma patients. Additionally, our meta-analysis revealed that patients with OM have an increased risk of developing infectious complications following HSCT compared to those without OM, with an odds ratio of 3.84 (95% CI: 2.51-5.86). The development of OM is related to various risk factors, and individuals with OM are at greater risk of infectious complications. Knowledge of these risk factors and outcomes will help clinicians identify high-risk individuals, prevent OM, and protect an immunocompromised population from subsequent life-threatening complications.

Indexed as

hemopoietic stem cell transplantsmeta-analysisoral mucositisoutcomesrisk factorssystematic reviews

Identifiers

PMID40867286
PMCPMC12384372

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.