title: Determinants of stimulated salivary flow among haematopoietic stem cell transplantation recipients.
abstract: OBJECTIVE
  The aetiology of hyposalivation in haematopoietic stem cell transplantation (HSCT) recipients is not fully understood. This study examined the effects of treatment-related aetiological factors, particularly medications, on stimulated salivary flow in HSCT recipients.
  
  
  METHODS
  Adult HSCT recipients (N = 118, 66 males, 27 autologous and 91 allogeneic transplants) were examined. Stimulated whole salivary flow rates (SWSFR) were measured before HSCT and at 6 and 12 months post-HSCT. Linear regression models were used to analyse the associations of medications and transplant-related factors with salivary flow rates, which were compared to salivary flow rates of generally healthy controls (N = 247).
  
  
  RESULTS
  The SWSFR of recipients were lower pre-HSCT (mean ± standard deviation, 0.88 ± 0.56 ml/min; P < 0.001), 6 months post-HSCT (0.84 ± 0.61; P < 0.001) and 12 months post-HSCT (1.08 ± 0.67; P = 0.005) than the SWSFR of controls (1.31 ± 0.65). In addition, hyposalivation (<0.7 ml/min) was more frequent among HSCT recipients pre-HSCT (P < 0.001), 6 months post-HSCT (P < 0.001) and 12 months post-HSCT (P = 0.01) than among controls. The SWSFR was observed to improve over time being significantly higher 12 months post-HSCT compared to pre-HSCT (P < 0.001). The observed decrease of salivary flow could not be explained by the examined transplant-related factors and medications.
  
  
  CONCLUSIONS
  Decreased stimulated salivary flow rates could not be explained by the examined factors alone; these findings indicate that hyposalivation in HSCT recipients exhibits a multifactorial aetiology.
  
  
  CONCLUSIONS
  All HSCT recipients should be considered to be at high risk of hyposalivation and consequent oral diseases, and they should be treated accordingly.
authors.affiliation: Institute of Preventive Dentistry and Oral Microbiology, School of Dental Medicine, University of Basel, Basel, Switzerland. matti.mauramo@helsinki.fi.|Institute of Dentistry, Scientific Research Laboratory, Biomedicum, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, FI-00014, Helsinki, Finland. matti.mauramo@helsinki.fi.
authors.forename: Matti
authors.initials: M
authors.lastname: Mauramo
authors.affiliation: Institute of Preventive Dentistry and Oral Microbiology, School of Dental Medicine, University of Basel, Basel, Switzerland.
authors.forename: Luzius
authors.initials: L
authors.lastname: Rohde
authors.affiliation: Institute of Preventive Dentistry and Oral Microbiology, School of Dental Medicine, University of Basel, Basel, Switzerland.
authors.forename: Adrian M
authors.initials: AM
authors.lastname: Ramseier
authors.affiliation: Department of Haematology, University Hospital Basel, Basel, Switzerland.
authors.forename: Alicia
authors.initials: A
authors.lastname: Rovó
authors.affiliation: Institute of Preventive Dentistry and Oral Microbiology, School of Dental Medicine, University of Basel, Basel, Switzerland.
authors.forename: Tuomas
authors.initials: T
authors.lastname: Waltimo
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013557:Switzerland; D014987:Xerostomia / Q000209:etiology*
keywords: Drugs; Haematology; Hyposalivation; Medications; Saliva; Stem cell transplantation