Oral integrity and salivary profile in myeloma patients undergoing high-dose therapy followed by autologous SCT.
The underlying mechanism of high-dose therapy (HDT)-related oral mucositis (OM) may be partly mediated by alterations in the normal salivary composition. This study evaluated salivary antioxidant and immunological capacities observed in myeloma patients suffering from HDT-related OM, and assessed potential contribution of these factors to OM development. Twenty-five consecutive myeloma patients treated with melphalan 200 mg/m(2) followed by autologous SCT were enrolled. Patients underwent a daily assessment for OM, and salivary samples were collected on days -3 and +7 of transplantation and analyzed for secretory IgA and antioxidant capacity. The degree of mucosal damage was assessed by measuring the salivary carbonyl and albumin (Alb) levels. OM, reported in 96% of patients, appeared to be most severe on 8 day after transplantation (range: +2 to +14). Clinical mucositis was associated with significant reduction in salivary secretory IgA (54%; P=0.05), and antioxidant activity, measured by total antioxidant status (40%; P=0.0004), antioxidant capacity (ImAnOx) (23%; P=0.002) and uric acid level (51%; P=0.006). The increase found in salivary Alb (119%; P=0.024) and carbonyl (28%; P=0.047) levels, indicates mucosal and oxidative damage, respectively. These salivary changes might enhance mucositis development and symptoms. Therapeutic interventions, enhancing antioxidative and immunological activities need to be investigated.
Avivi
I
I
Department of Hematology and Bone Marrow Transplantation, Rambam Medical Center, Haifa, Israel.
Avraham
S
S
Koren-Michowitz
M
M
Zuckerman
T
T
Aviv
A
A
Ofran
Y
Y
Benyamini
N
N
Nagler
A
A
Rowe
J M
JM
Nagler
R M
RM
D000328:Adult; D000368:Aged; D000418:Albumins / Q000032:analysis; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000975:Antioxidants / Q000032:analysis; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009055:Mouth / Q000473:pathology*; D052016:Mucositis / Q000139:chemically induced* / Q000209:etiology; D009101:Multiple Myeloma / Q000150:complications* / Q000628:therapy; D018384:Oxidative Stress; D012463:Saliva / Q000737:chemistry*; D014182:Transplantation, Autologous
D000418:Albumins; D000970:Antineoplastic Agents; D000975:Antioxidants; D007070:Immunoglobulin A; D008558:Melphalan