Early salivary changes in multiple myeloma patients undergoing autologous HSCT

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Abstract

Objective: One explorative observational study in two parts was performed to examine early salivary changes in relation to oral mucositis (OM) in multiple myeloma patients treated with high-dose melphalan and autologous haematopoietic stem cell transplantation (HSCT). As cryotherapy was introduced after part A as regular care, its effect on OM could be evaluated. Methods: Unstimulated whole-mouth saliva (UWS) and stimulated whole-mouth saliva (SWS) were collected, and OM was scored with the Oral Mucositis Nursing Instrument (OMNI) at days −3, 0, 4, 7, 11 and 14 after HSCT. Salivary flow rate, total protein (BCA), mucin 5B, albumin (western blot), total IgA, lactoferrin and myeloperoxidase levels (ELISA) were determined. Results: Trends of decreasing UWS and SWS flow rates and total IgA levels were observed. At days 7 and 11, increases in lactoferrin and albumin levels were found in UWS and SWS. A positive correlation was found between OMNI scores and albumin and lactoferrin levels in SWS (R2 =.56, p =.029 and R2 =.49, p =.043, respectively). In part B, cryotherapy significantly lowered peak OMNI scores. Conclusion: Compositional changes in saliva reflecting inflammation were found in the first days after HSCT, and the use of cryotherapy in the second part was associated with decreased OM severity.

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van Leeuwen, S. J. M., Proctor, G. B., Potting, C. M. J., ten Hoopen, S., van Groningen, L. F. J., Bronkhorst, E. M., … Huysmans, M. C. D. N. J. M. (2018). Early salivary changes in multiple myeloma patients undergoing autologous HSCT. Oral Diseases, 24(6), 972–982. https://doi.org/10.1111/odi.12866

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