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Early salivary changes in multiple myeloma patients undergoing autologous HSCT
Author(s) -
Leeuwen SJM,
Proctor GB,
Potting CMJ,
ten Hoopen S,
Groningen LFJ,
Bronkhorst EM,
Blijlevens NMA,
Huysmans MCDNJM
Publication year - 2018
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/odi.12866
Subject(s) - mucositis , lactoferrin , saliva , medicine , cryotherapy , albumin , multiple myeloma , gastroenterology , hematopoietic stem cell transplantation , transplantation , surgery , chemistry , chemotherapy , biochemistry
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 ( R 2 = .56, p = .029 and R 2 = .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.