Mouthcare prophylaxis protocol
Patients should start off with different levels of mouthcare depending on the mucositis potential of their therapy. As mucositis occurs then additional therapies should be added in.
Introduction
Patients should start off with different levels of mouthcare depending on the mucositis potential of their therapy. As mucositis occurs then additional therapies should be added in. (See Treatment of Established Mucositis in Mouth care and Mucositis guideline.)
Group A: Protocols with very high Mucositis-inducing potential
AML
Autologous stem cell rescue
Allogenic stem cell transplantation
Therapy
Cryotherapy (sucking cold ice blocks for 30 minutes is recommended prior to melpahlan)
Basic mouthcare BD in Mouth care and Mucositis guideline
Antifungal prophylaxis as recommended
Commence Oral Assessment Guide if neutrophils < 1.0
Increase frequency of toothbrushing to TDS.
Group B: Protocols with high Mucositis-inducing potential
ALL - Induction and reinduction/reconsolidation blocks
Relapsed ALL
Multi-agent therapy for poor prognosis solid tumours
Infant ALL - all phases except maintenance
High risk Neuroblastoma
Ewings sarcoma protocols
Osteosarcoma protocols
High risk B-cell NHL protocols
Anaplastic Large Cell Lymphoma protocol
Brain Tumour patients receiving chemotherapy or radiation therapy and Dexamethasone.
Therapy
Basic mouthcare BD
Commence Oral Assessment Guide if neutrophils < 1.0
Increase frequency of toothbrushing to TDS.
Group C: Standard risk (low Mucositis-inducing potential)
All other patients receive basic mouthcares only.