Affect of Achillea millefolium in Prophylaxis of oral mucositis induced by chemotherapy in AML patients

Abstract

Introduction: Oral mucositis is a common complication of chemotherapy. Various methods and medications have been using to treat oral mucositis. Achillea millefolium L. has anti-inflammatory and antimicrobial effects. Aim: The aim of this study is evaluation of the Achillea millefolium mouthwash effect in prophylaxis and treatment of oral mucositis induced by chemotherapy in patients with Acute Myeloid Leukemia (AML). Materials and methods: In this randomized clinical trial, 30 patients with AML, who received 3+7 or 5+2 regimen, were randomly assigned to intervention (n=15) and control (n=15) groups. The intervention group gargled 10 ml Achillea millefolium mouthwash and also 15 ml Chlorhexidine mouthwash 2 times a day for 20 days from the first day of chemotherapy while the control group gargled 15 mL of Chlorhexidine mouthwash 2 times a day. Oral mucositis and its complications were assessed at the beginning of the intervention, 5, 10, 15 and 20 days of the study. Results: Intervention group had better mean oral mucositis score compared to control group which was significant in day 20 (P value = 0.002). Intervention group had shown decrease trend in both pain occurrence and painkiller consumption. In day 20 fewer patients had pain, and painkiller consumption was lower in intervention group in compare with control group (P value = 0.002, 0.001, respectively). Oral mucositis score had shown development during treatment but in days 10th and 20th results had shown significant different between intervention and control group (P value = 0.021, 0.002, respectively). In comparison of sever and mild mucositis, results had shown that intervention group was significantly better than control group (P value = 0.018). Conclusion: In conclusion, Achillea millefolium extract improved oral mucositis better than chlorhexidine. Although Achillea mouthwash was not effective in prophylaxis of mucositis but it had shown better effects on pain and oral mucositis.