A longitudinal follow-up of salivary secretion in bone marrow transplant patients.
Salivary gland dysfunction is a common sequela of the bone marrow transplantation procedure. We determined the effect of different bone marrow transplantation protocols on parotid salivary flow rate. Salivary secretion was substantially reduced during conditioning of all the recipients. A gradual flow rate reconstitution could be detected as soon as a few days after the bone marrow transplantation. Eight patients conditioned with total lymph node irradiation and chemotherapy or chemotherapy alone displayed earlier and complete recovery of saliva secretions 2 to 5 months after the grafting. Recovery was delayed and incomplete when total body irradiation was added to the conditioning regimen (seven patients). Six of these patients also developed graft-versus-host disease. The results suggest that total body irradiation induces irreversible damage to the parotid glands resulting in profound xerostomia followed by opportunistic infections. Chemotherapy with or without total lymph node irradiation does not induce such damage.
Chaushu
G
G
Hebrew University, Hadassah School of Dental Medicine and Medicine, Jerusalem, Israel.
Itzkovitz-Chaushu
S
S
Yefenof
E
E
Slavin
S
S
Or
R
R
Garfunkel
A A
AA
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015182:Lymphatic Irradiation / Q000009:adverse effects; D008212:Lymphocyte Depletion; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000187:drug effects / Q000378:metabolism* / Q000528:radiation effects; D012463:Saliva / Q000378:metabolism*; D012636:Secretory Rate; D013997:Time Factors; D014916:Whole-Body Irradiation / Q000009:adverse effects; D014987:Xerostomia / Q000209:etiology*
D007166:Immunosuppressive Agents