Developing Photobiomodulation Program for a Pediatric Oncology Hospital-PRE-READ DEVELOPING A PHOTOBIOMODULATION PROGRAM FOR A PEDIATRIC ONCOLOGY HOSPITAL

PRE-READ DEVELOPING A PHOTOBIOMODULATION PROGRAM FOR A PEDIATRIC ONCOLOGY HOSPITAL

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This study evaluated whether photobiomodulation (PBM)—a low-intensity light therapy—can feasibly prevent and treat severe oral mucositis in children and adolescents undergoing allogeneic hematopoietic cell transplant (HCT) for acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML). Oral mucositis is a common, painful toxicity after high-dose chemotherapy, often peaking 6–12 days post-transplant and contributing to infection risk, poor oral intake, need for parenteral nutrition and opioids, longer hospital stays, and higher costs.<br /><br />From February 2020 to May 2021, 40 pediatric patients received daily PBM starting on day 1 of conditioning through engraftment (ANC ≥500 for two consecutive days) or day 20. PBM was delivered using a THOR LX2 device across six treatment sites (five extraoral regions plus one intraoral “lollipop” probe), with each application lasting 60 seconds. Mucositis severity was scored daily using CTCAE v5. Feasibility was defined as successfully treating four or more sites in at least 75% of encounters.<br /><br />Across 1,035 encounters, feasibility was high: 93.3% of encounters met the “successful treatment” definition. Efficacy was assessed against an expected Grade 3 mucositis rate of 51% (based on historical data and a targeted 20% effect size). Only 20% of PBM-treated patients developed Grade 3 mucositis (average 2.4 days, range 1–5), meeting the study’s efficacy criteria.<br /><br />Compared with matched controls (not treated during COVID-related accrual holds), PBM patients had shorter duration of Grade 1–2 mucositis, overall less severe mucositis, and fewer hospitalization days (32.4 vs. 40.2 days). The authors conclude PBM is feasible and effective in this setting and note it is now supported by Children’s Oncology Group guidelines for mucositis prevention/treatment in allogeneic HCT and head/neck radiation.

Keywords

photobiomodulation

PBM light therapy

oral mucositis prevention

pediatric allogeneic hematopoietic cell transplant

acute lymphoblastic leukemia

acute myeloid leukemia

high-dose chemotherapy toxicity

CTCAE v5 mucositis grading

THOR LX2 device

hospital length of stay reduction