Subjective Oral Dryness following Hematopoietic Cell Transplantation: A Report from the Orastem Study.

Autor: Bulthuis MS; Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands. Electronic address: Marjolein.Bulthuis@radboudumc.nl., van Leeuwen SJM; Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands., Thomas RZ; Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands., van Gennip LLA; Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands., Whiteside HM; Wake Forest University School of Medicine, Division of Public Health Sciences, Department of Biostatistics and Data Science, Winston-Salem, North Carolina., Isom S; Wake Forest University School of Medicine, Division of Public Health Sciences, Department of Biostatistics and Data Science, Winston-Salem, North Carolina., Kline DM; Wake Forest University School of Medicine, Division of Public Health Sciences, Department of Biostatistics and Data Science, Winston-Salem, North Carolina., Laheij AMGA; Department of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands; Department of Oral, Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Raber-Durlacher JE; Department of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands; Department of Oral, Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Hasséus B; Department of Oral medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden., Johansson JE; Department of Hematology and Coagulation, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden., Hovan AJ; Oral Oncology and Dentistry, British Columbia Cancer, Vancouver, British Columbia, Canada., Brennan MT; Department of Oral Medicine/Oral & Maxillofacial Surgery, Atrium Health Carolinas Medical Center, Charlotte, North Carolina; Department of Otolaryngology/Head & Neck Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina., von Bültzingslöwen I; Department of Oral Microbiology and Immunology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden., Huysmans MDNJM; Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands., Blijlevens NMA; Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands.
Jazyk: angličtina
Zdroj: Transplantation and cellular therapy [Transplant Cell Ther] 2024 Apr; Vol. 30 (4), pp. 446.e1-446.e11. Date of Electronic Publication: 2024 Jan 17.
DOI: 10.1016/j.jtct.2024.01.067
Abstrakt: Xerostomia, or subjective oral dryness, is a serious complaint after hematopoietic cell transplantation (HCT). Xerostomia is rated as one of the most bothersome symptoms by HCT recipients, negatively affecting quality of life. This substudy of the Orastem study, a prospective longitudinal, international, observational, multicenter study, aimed to describe the prevalence and severity of xerostomia following HCT. Furthermore, the effect of the conditioning regimen, type of transplantation, and oral mucosal changes related to chronic graft-versus-host disease (cGVHD) in the development of xerostomia were studied. All HCT recipients rated xerostomia on a scale of 0 to 10 before the conditioning regimen, several times early post-HCT, and at 3 months post-HCT, and only allogeneic HCT recipients also rated xerostomia at 6 and 12 months post-HCT. In addition, stimulated whole mouth saliva was collected several times. Linear regression models and longitudinal mixed-effects models were created to investigate the influence of risk indicators on xerostomia. A total of 99 autologous and 163 allogeneic HCT recipients were included from 6 study sites in Sweden, Canada, the Netherlands, and the United States. The prevalence of xerostomia was 40% before the conditioning regimen, 87% early post-HCT, and 64% at 3 months post-HCT. Complaints after autologous HCT were transient in nature, while the severity of xerostomia in allogeneic HCT recipients remained elevated at 12 months post-HCT. Compared to autologous HCT recipients, allogeneic HCT recipients experienced 1.0 point more xerostomia (95% confidence interval [CI], .1 to 2.0) early post-HCT and 1.7 points more (95% CI, .4 to 3.0) at 3 months post-HCT. Allogeneic HCT recipients receiving a high-intensity conditioning regimen experienced more xerostomia compared to those receiving a nonmyeloablative or reduced-intensity conditioning regimen. The difference was 2.0 points (95% CI, 1.1 to 2.9) early post-HCT, 1.8 points (95% CI, .3 to 3.3) after 3 months, and 1.7 points (95% CI, .0 to 3.3) after 12 months. Total body irradiation as part of the conditioning regimen and oral mucosal changes related to cGVHD did not significantly influence the severity of xerostomia. Conditioning regimen intensity was a significant risk indicator in the development of xerostomia, whereas total body irradiation was not. Allogeneic HCT recipients experienced more xerostomia than autologous HCT recipients, a difference that cannot be explained by a reduction in stimulated salivary flow rate or the development of oral mucosal changes related to cGVHD.
(Copyright © 2024 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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