Abstract

Background: Allogeneic hematopoietic cell transplantation (HCT) often leads to oral mucositis (OM) and odynophagia, which increase morbidity and treatment costs. Sucralfate has been proposed for mucosal protection, but its role in managing mucositis-induced odynophagia remains unclear. Methods: We conducted a case-control study comparing allogeneic HCT recipients treated with sucralfate oral suspension for odynophagia (study group) to a matched control group without sucralfate. Outcomes assessed included incidence and severity of OM, duration of parenteral nutrition, analgesic use, hospital length of stay, and treatment costs. Results: The incidence and severity of OM were similar between groups. However, sucralfate use was associated with a significant reduction in parenteral nutrition duration (2.62 vs. 6.64 days, p=0.001) and lower consumption of morphine, fentanyl patches, and hexomedine (p < 0.05). No differences were observed in tramadol or pethidine use. Overall treatment costs were reduced by 51% in the sucralfate group despite the additional cost of the drug. Adherence to sucralfate therapy was high (>80%), with few adverse effects. Conclusion: Sucralfate effectively reduces odynophagia-related parenteral nutrition and opioid use in allogeneic HCT recipients with mucositis, representing a potential costeffective supportive care strategy. Randomized controlled trials are needed to confirm these findings.

Keywords

allogeneic hematopoietic cell transplantation, mucositis, odynophagia, sucralfate