Lesions in the oral mucosa are a common complication of a high-dose chemotherapy conditioning regimen often given to patients who undergo autologous hematopoietic stem cell transplantation (AHSCT) for multiple myeloma (MM). Cryotherapy, a complementary approach that entails applying ice chips, is often recommended for oral mucositis (OM), despite a lack of standard OM protocols.

A team of researchers in Turkey set out to evaluate the effect of cryotherapy on preventing OM and on patients’ oral pH values. They analyzed data from 32 patients with MM who were undergoing AHSCT, having completed a conditioning regimen of high-dose melphalan. Sixteen participants received cryotherapy on the day they received the conditioning regimen; 16 participants were in the control group. These study findings were published in Seminars in Oncology Nursing.

They found that cryotherapy didn’t statistically change the incidence of oral mucositis. It didn’t decrease the duration or the severity of OM, and only significantly affected oral pH values before and 1 day after chemotherapy.

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Their results might lead some to believe that cryotherapy would be unnecessary. But the researchers noted that cryotherapy is an easy-to-use, inexpensive method with no side effects, so “it would be beneficial to continue cryotherapy to prevent the development of OM in patients with cancer receiving drugs with short half-life such as melphalan,” they wrote.

These researchers acknowledged that in some aspects, their results in this study differed from the literature, perhaps due to differences in treatment protocols and in the patient groups.  For example, oral pH values either remained the same or changed in both the treatment and control groups, and oral pH values changed from alkaline to acidic, even in the patients who received cryotherapy.

However, the researchers cautioned that the results from their study can’t be generalized because the sample sizes were small, and randomization wasn’t possible. They recommended “that future studies should be conducted in a single center and randomization should be performed.”


Baysal E, Sari D, Vural F, et al. pH value in multiple myeloma patients undergoing autologous stem cell transplantation. Semin Oncol Nurs. May 15, 2021. doi:10.1016/j.soncn.2021.151146