Zinc Sulfate Improves Chemotherapy-Induced Mucositis Outcomes in Leukemia

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After 2 weeks, twice as many participating patients who received placebo instead of zinc sulfate developed mucositis.
After 2 weeks, twice as many participating patients who received placebo instead of zinc sulfate developed mucositis.

Zinc sulfate prevents and reduces the severity of chemotherapy-induced mucositis among patients with leukemia, according to a study published the European Journal of Oncology Nursing.

Aggressive chemotherapy regimens have led to improved control and survival outcomes for patients with cancer but also causes a high rate of mucositis, an adverse event that negatively affects patient quality of life. Results from previous trials studying zinc sulfate for mucositis symptom improvement have been mixed, and there is a paucity of data exploring zinc use among patients with leukemia.

For this triple blind study, researchers randomly assigned 101 patients with leukemia who received chemotherapy (eg, 5-FU, cytarabine, doxorubicin, daunorubicin, vincristine, cisplatin, cyclophosphamide) and not currently experiencing mucositis to receive oral zinc sulfate 50 mg or placebo. Patients received treatment 3 times a day for 2 weeks from the start of chemotherapy, and were evaluated at baseline, 4th, 7th, and 14th day after chemotherapy initiation.

Results showed that 75% of patients in the zinc sulfate arm did not develop mucositis by day 14 compared with 47.2% of patients in the placebo arm (P =.01). Twice as many patients who received placebo vs zinc sulfate developed mucositis by day 14 (54.3% vs 25.0%). Patients who received zinc sulfate also reported experiencing less severe mucositis than patients in the control arm.

There were no statistically significant differences in the onset of mucositis between both study arms.

The authors concluded that “as zinc sulfate prevented and relieved mucositis in leukemia patients under chemotherapy, using zinc sulfate is recommended in clinical setting. Yet, further studies are suggested to confirm these findings.”


Rambod M, Pasyar N, Ramzi M. The effect of zinc sulfate on prevention, incidence, and severity of mucositis in leukemia patients undergoing chemotherapy. Eur J Oncol Nurs. 2018;33:14-21. 

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