Unveiling the culprits: A retrospective case-control study on risk factors of mucositis in autologous stem cell transplantation

The risk factors for mucositis in patients undergoing autologous hematopoietic stem cell transplantation (AHSCT) are complex and encompass conditioning regimens, patient demographics, and microbiological alterations. A comprehensive understanding of these factors is essential for the development of targeted interventions aimed at reducing the severity of mucositis and enhancing patient outcomes. This study sought to identify the risk factors associated with mucositis in patients undergoing AHSCT in the blood transplantation purification ward of the First Affiliated Hospital of Soochow University and to propose strategies for its prevention. A retrospective analysis was conducted on hematological patients (N = 104) who developed mucositis following AHSCT in our transplantation purification ward between June 2021 and March 2024. Patients were categorized based on the severity of mucositis using grading systems from the World Health Organization or the Common Terminology Criteria for Adverse Events. Potential risk factors, including conditioning regimens, post-transplant infections, and other clinical variables, were evaluated using univariate and multivariate logistic regression analyses. Univariate analysis identified the BEAM conditioning regimen, comprising carmustine, etoposide, cytarabine, and melphalan (P = .03), along with post-transplant infections (P = .02), as significant risk factors for the onset of mucositis. Subsequent multivariate analysis corroborated the carmustine, etoposide, cyarabine, and melphalan (BEAM regimen) as an independent risk factor (P = .01). Other variables, such as age, type of underlying disease, and duration of neutropenia, did not exhibit a significant association with the development of mucositis. In conclusion, the BEAM regimen and post-transplant infections markedly elevate the risk of mucositis in patients undergoing AHSCT. Early identification of individuals at high risk, optimization of conditioning regimens, rigorous infection control protocols, and proactive oral care interventions may reduce the incidence and severity of mucositis, thereby improving patient outcomes. Further prospective studies are warranted to validate these findings and refine preventive strategies.