Effects of Topical Vitamin E Mouthwash in Preventing Oral Mucositis in Allogenic Hematopoietic Stem Cell Transplant Patients: A Double- Blind, Placebo-Controlled Trial

Background: Oral mucositis is considered a frequent complication of conditioning regimen in patients undergoing hematopoietic stem cell transplantation (HSCT). Mucositis develops due to direct and indirect damage to the epithelial cells and production of reactive oxygen species (ROS). Vitamin E has shown positive effects in reducing production of ROS or improving its elimination. The aim of this study was to evaluate the effects of vitamin E mouthwash in lowering the incidence and severity of acute mucositis in patients undergoing allogenic HSCT. Methods: The current study was designed as a double bind, placebo controlled randomized clinical trial. Eighty patients were randomized in a 1 to 1 method to receive either placebo or vitamin E mouthwash. Patients in vitamin E group received 400 International Units of vitamin E in form of mouthwash twice daily and placebo group received a mouthwash with equal composition but without vitamin E, starting the day of the chemotherapy initiation and continuing it for 14 days. Results: Vitamin E mouthwash effectively reduced the duration of oral mucositis compared to placebo (P-value 0.02). The difference between placebo and vitamin E groups in terms of mucositis severity did not reach statistical significance (P=0.35). No difference in length of hospital stay was observed (P=0.46). Conclusion: Vitamin E mouthwash could effectively reduce the duration of oral mucositis in allogenic HSCT patients. Further studies are required to show the effects of topical vitamin E in preventing the development of oral mucositis.