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Autografting

Oral integrity and salivary profile in myeloma patients undergoing high-dose therapy followed by autologous SCT

Bone Marrow Transplantation volume 43, pages 801–806 (2009)Cite this article

Abstract

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/m2 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.

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Acknowledgements

We thank Mrs S Gan for her assistance in the statistical analysis of this paper.

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Author notes

  1. I Avivi and S Avraham: These authors contributed equally to this study.

Authors and Affiliations

  1. Department of Hematology and Bone Marrow Transplantation, Rambam Medical Center, Haifa, Israel

    I Avivi, S Avraham, T Zuckerman, A Aviv, Y Ofran, N Benyamini & J M Rowe

  2. Technion—Israel Institute of Technology, Haifa, Israel

    I Avivi & J M Rowe

  3. Department of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel

    M Koren-Michowitz & A Nagler

  4. Department of Oral and Maxillofacial Surgery, Oral Biochemistry Laboratory, Technion—Israel Institute of Technology, Haifa, Israel

    R M Nagler

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  1. I Avivi
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Correspondence to R M Nagler.

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Avivi, I., Avraham, S., Koren-Michowitz, M. et al. Oral integrity and salivary profile in myeloma patients undergoing high-dose therapy followed by autologous SCT. Bone Marrow Transplant 43, 801–806 (2009). https://doi.org/10.1038/bmt.2008.387

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  • DOI: https://doi.org/10.1038/bmt.2008.387

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