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Not yet recruitingNCT07809451SOC-HSCTUpdated Sep 9, 2026

Effect of a Standardized Oral Care Program on Oral Mucositis in Children Undergoing Hematopoietic Stem Cell Transplantation: A Randomized Controlled Trial(SOC-HSCT)

An interventional study of Standardized Oral Care Intervention and Routine Oral Care in Oral Mucositis and Hematopoietic Stem Cell Transplantation (HSCT), sponsored by Nanfang Hospital, Southern Medical University. Not yet recruiting at 1 site in China. Open to participants aged 1 Year to 18 Years. Per ClinicalTrials.gov, last updated 2026-09-09.

Sponsored by Nanfang Hospital, Southern Medical University · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
126
Allocation
Randomized
Ages
1 Year to 18 Years
Sex
All
01

Study summary

Oral mucositis is one of the most common and debilitating complications in pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Severe oral mucositis can lead to pain, nutritional impairment, infection, prolonged hospitalization, and increased healthcare costs. This randomized controlled trial aims to evaluate whether a standardized oral care program consisting of caregiver education, supervised tooth brushing, sodium bicarbonate mouth rinsing, oral moisturizing, and compliance monitoring can reduce the incidence and severity of oral mucositis compared with routine oral care. A total of 126 pediatric HSCT recipients will be randomly assigned in a 1:1 ratio to the intervention or control group. Clinical outcomes, oral pain, inflammatory biomarkers, oral microbiota, and metabolomic profiles will be evaluated throughout the transplantation period.

Read the detailed description

Oral mucositis is one of the most frequent and clinically significant complications in pediatric patients receiving hematopoietic stem cell transplantation (HSCT). Characterized by painful inflammation and ulceration of the oral mucosa, oral mucositis can substantially impair oral intake, nutritional status, communication, and quality of life. In severe cases, it may increase the risk of bloodstream infections, require opioid analgesia, prolong hospitalization, and affect the overall course of transplantation.

Currently, preventive and supportive strategies for oral mucositis in HSCT patients mainly include oral hygiene maintenance, antimicrobial interventions, pain management, and symptomatic treatment. However, the incidence and severity of oral mucositis remain high, particularly in pediatric HSCT recipients, due to factors including intensive conditioning regimens, immature oral care behaviors, altered immune status, and changes in the oral microbiome. Therefore, effective, standardized, and feasible preventive oral care strategies are still needed.

Emerging evidence suggests that maintenance of oral microbial homeostasis and improvement of oral hygiene may play important roles in reducing mucosal injury and preventing the progression of oral mucositis. However, existing oral care protocols vary considerably among institutions, and the effectiveness of comprehensive standardized oral care programs in pediatric HSCT populations requires further evaluation.

This clinical trial aims to evaluate the effectiveness of a standardized oral care intervention program for preventing and reducing oral mucositis in pediatric patients undergoing HSCT. The intervention integrates structured oral hygiene management, oral care education, adherence monitoring, and supportive oral management throughout the transplantation process.

The study is designed to provide clinical evidence regarding the role of standardized oral care in improving oral health outcomes and reducing oral mucositis-related complications in pediatric HSCT recipients. The results may contribute to establishing evidence-based oral care protocols and improving supportive care strategies for children undergoing hematopoietic stem cell transplantation.

02

Conditions studied

  • Oral Mucositis
  • Hematopoietic Stem Cell Transplantation (HSCT)

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Keywords

  • Oral mucositis
  • Hematopoietic stem cell transplantation
  • Pediatric patients
  • Oral care
  • Supportive care
03

Who can participate

Ages eligible
1 Year to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • -Patients aged 1-18 years who undergo hematopoietic stem cell transplantation.
  • Patients scheduled to receive conditioning therapy before hematopoietic stem cell transplantation.
  • Patients and/or their legal guardians provide informed consent to participate in the study.
  • Patients are able to receive oral care intervention and complete oral mucositis assessments during the study period.

Exclusion criteria

Exclusion Criteria:

  • Patients with pre-existing oral mucosal diseases or oral ulcers before transplantation.
  • Patients with severe systemic conditions that may interfere with oral mucositis assessment.
  • Patients who have received interventions specifically targeting oral mucositis prevention before enrollment.
  • Patients or guardians who refuse to participate or withdraw informed consent.
  • Patients who are unable to complete follow-up assessments during the study period.
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
126 participants (estimated)

Study arms

  • Experimental
    Standardized Oral Care Intervention Group

    Participants will receive a standardized oral care intervention during the hematopoietic stem cell transplantation period, including structured oral hygiene management, oral care education, and adherence monitoring.

    Behavioral: Standardized Oral Care Intervention

  • Active comparator
    Routine Oral Care Group

    Participants will receive routine oral care according to the current institutional practice during the hematopoietic stem cell transplantation period.

    Behavioral: Routine Oral Care

Interventions

  • BehavioralStandardized Oral Care Intervention

    The intervention consists of standardized oral care procedures, including oral hygiene management, oral care education, oral moisturizing, and compliance monitoring throughout the transplantation period.

  • BehavioralRoutine Oral Care

    Participants will receive routine oral care provided according to institutional practice.

05

What researchers measure

Primary outcomes

  1. Incidence of Oral Mucositis

    The incidence of oral mucositis will be assessed according to the World Health Organization (WHO) oral mucositis grading criteria. The proportion of participants who develop oral mucositis of grade ≥1 at any time during the observation period from the day of hematopoietic stem cell transplantation (Day 0) through day 30 after transplantation (Day +30) will be compared between the intervention group and the control group.

    Time frame: From Day 0 to Day +30 after hematopoietic stem cell transplantation

Secondary outcomes

  1. Severity of Oral Mucositis

    The severity of oral mucositis will be evaluated according to the WHO oral mucositis grading criteria. The maximum mucositis grade and the proportion of participants who develop moderate to severe oral mucositis (grade ≥3) at any time from Day 0 through Day +30 after hematopoietic stem cell transplantation will be recorded and compared between the intervention group and the control group.

    Time frame: From Day 0 to Day +30 after hematopoietic stem cell transplantation

Other outcomes

  1. Oral Pain Score

    Oral pain intensity will be assessed using the Faces Visual Analog Scale (VAS). Pain scores will be assessed during the observation period, and the mean and peak pain scores from Day 0 through Day +30 after hematopoietic stem cell transplantation will be analyzed.

    Time frame: From Day 0 to Day +30 after hematopoietic stem cell transplantation

  2. Salivary Inflammatory Cytokine Levels

    Unstimulated saliva samples will be collected at five predefined time points during the peri-transplant period. Salivary inflammatory cytokine levels, including interleukin-6 (IL-6) and interleukin-1 beta (IL-1β), will be measured using enzyme-linked immunosorbent assay (ELISA). Changes in cytokine levels across the five time points will be evaluated, and their associations with the incidence and severity of oral mucositis will be explored.

    Time frame: Baseline (T0), Day 0 (T1), Day +7 (T2), Day +14 (T3), and Day +30 (T4) after hematopoietic stem cell transplantation

  3. Hospital Stay and Medical Costs

    The total length of hospital stay, total hospitalization costs, and the proportion of participants requiring specific treatments related to oral mucositis will be recorded and compared between the intervention group and the control group.

    Time frame: From Day 0 after hematopoietic stem cell transplantation to hospital discharge

06

Study locations

1 site
  • Nanfang Hospital, Southern Medical University
    Guangzhou, Guangdong 510515, China
    • Ting Chen, PhD · Contact · chent@smu.edu.cn · +86-020-62787939
    • Zhuoting yuan · Contact · 18279667334@163.com · +86-18279667334
    • Ting Chen, PhD · Principal investigator
    • Zhuoting Yuan · Sub investigator
    • Yan Lin · Sub investigator
07

References and documents

Publications

  • Raber-Durlacher JE, Zadik Y, Treister NS, Stempler N, Bruno JS, Epstein JB, Elad S. MASCC/ISOO clinical practice statement: Current understanding on controversies in basic oral care in hemato-oncology and hematopoietic cell transplantation. Support Care Cancer. 2024 Jul 25;32(8):550. doi: 10.1007/s00520-024-08690-1. PubMed 39048882 ↗
  • Potting CMJ, van Leeuwen SJM, Kurstjens MH, Bronkhorst EM, Thomas RZ, Blijlevens NMA, Huysmans MDNJM. A randomized controlled trial of manual versus powered tooth brushing during haematopoietic stem cell transplantation. Oral Dis. 2022 Oct;28(7):1987-1994. doi: 10.1111/odi.13899. Epub 2021 May 20. PubMed 33964053 ↗
  • de Lima Martins JO, Carlos ACAM, Costa GAJ, Ribeiro RS, Malta CEN, Borges MMF, de Moura JFB, de Arruda LM, Costa FWG, de Barros Silva PG. Oral hygiene protocols reduce the severity and incidence of oral mucositis during antineoplastic treatment: a systematic review and meta-analysis of randomized and non-randomized clinical trials. Support Care Cancer. 2023 Jul 21;31(8):480. doi: 10.1007/s00520-023-07858-5. PubMed 37477721 ↗
  • Agholme MB, Dahllof G, Torlen JK, Majorana A, Brennan MT, von Bultzingslowen I, Tan PL, Hu S, Sim YF, Hong C. Incidence, severity, and temporal development of oral complications in pediatric allogeneic hematopoietic stem cell transplant patients - a multicenter study. Support Care Cancer. 2023 Nov 16;31(12):702. doi: 10.1007/s00520-023-08151-1. PubMed 37971651 ↗
  • Alhussain A, Alkhayal Z, Ayas M, Abed H. Prevalence and risk factors of oral mucositis in paediatric patients undergoing haematopoietic stem cell transplantation. Oral Dis. 2022 Apr;28(3):657-669. doi: 10.1111/odi.13777. Epub 2021 Feb 2. PubMed 33453145 ↗
  • Patel P, Robinson PD, Baggott C, Gibson P, Ljungman G, Massey N, Ottaviani G, Phillips R, Revon-Riviere G, Treister N, White M, Cabral S, Dupuis L, Sung L. Clinical practice guideline for the prevention of oral and oropharyngeal mucositis in pediatric cancer and hematopoietic stem cell transplant patients: 2021 update. Eur J Cancer. 2021 Sep;154:92-101. doi: 10.1016/j.ejca.2021.05.013. Epub 2021 Jul 9. PubMed 34252760 ↗

Individual participant data

Plan to share: No — Individual participant data will not be shared because this study involves pediatric hematopoietic stem cell transplantation recipients and includes sensitive clinical information and biological sample-related data. To protect participant privacy and confidentiality, data will be managed and stored according to ethical approval requirements and institutional policies.

08

Registry details

Key details

Study ID
NCT07809451
Lead sponsor
Nanfang Hospital, Southern Medical University
Responsible party
Sponsor
First posted
Sep 9, 2026
Start date
Sep 1, 2026 (estimated)
Primary completion
Sep 1, 2029 (estimated)
Completion
Sep 1, 2030 (estimated)
Last update
Sep 9, 2026

Study contacts

Zhuoting Yuan
Contact
18279667334@163.com
+86-18279667334
Yan Lin
Contact
linyandent@163.com
+86-19128424850
Ting Chen, PhD
principal investigator · Nanfang Hospital, Southern Medical University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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