Low Level Laser Therapy May Prevent Oral Mucositis During HSCT Conditioning

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LLLT can prevent or eliminate severe OM, improving patient quality of life.
LLLT can prevent or eliminate severe OM, improving patient quality of life.
The following article features coverage from the 2018 Oncology Nursing Society's Annual Conference in Washington, DC. Click here to read more of Oncology Nurse Advisor's conference coverage. 

Low level laser therapy (LLLT) may help prevent oral mucositis (OM) in patients with hematologic cancers undergoing hematopoietic stem cell transplant (HSCT), according to findings presented at the 2018 Oncology Nursing Society (ONS) Annual Congress.

“OM is one of the most incapacitating side effects experienced by HSCT patients. Approximately 97% of patients who receive busulfan experience mouths sores,” said Ashley Layton, RN, BSN, OCN. Patients experience high levels of pain and are maintained by multiple medications to manage OM-associated symptoms, severely reducing their quality of life (QOL). Furthermore, many patients are unable to receive additional conditioning therapies — such as methotrexate — due to toxicity. 

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For this study, researchers assessed the impact of LLLT in 19 patients treated with busulfan — an alkylating chemotherapy conditioning drug commonly used before HSCT — at the University of Pittsburgh Medical Center (UPMC) Shadyside Hospital. LLLT was administered on Mondays, Wednesdays, and Fridays closest to the first day of busulfan administration and was continued until patient absolute neutrophil count (ANC) was at least 500 for 2 days consecutively.  Patients were also counseled on dental hygiene and proper dental self-care.

Results showed that no patients developed grade 4 OM, and 12 of the 18 participants developed grade 3 OM. Grade 1 and 2 OM were reported in 6 patients (3 patients each). 

Eight patients were able to continue the HSCT conditioning regimen and receive all necessary doses of methotrexate, and only 6 patients required patient-controlled analgesia to manage pain. 

LLLT can prevent or eliminate severe OM, improving patient quality of life by reducing pain and allowing completion of therapy. Layton concluded by saying, “With proven efficacy, UPMC Shadyside has now expanded to treating other oncology patient populations who are at increased risk for developing OM.”


Layton A, Bartell E, Hanchett S, Quinn A. Implementing preventative low level laser therapy in hematopoietic stem cell transplant patients to prevent oral mucositis: follow up of patient outcomes. Oral presentation at: ONS 43rd Annual Congress; May 17-20, 2018; Washington, DC.

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