Determinants of stimulated salivary flow among haematopoietic stem cell transplantation recipients

Mauramo, Matti; Rohde, Luzius; Ramseier, A.M.; Rovó, Alicia; Waltimo, Tuomas

doi:10.1007/s00784-016-1760-0

Cited by 10 publications

(30 citation statements)

References 19 publications

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“…Thus, the former studies may exaggerate the regeneration potential of salivary tissues. 16,17,27,28 Nonetheless, in our previous study, hyposalivation and persisting sicca symptoms were observed to be relatively common several years post-HSCT. 8 Hyposalivation was not associated with acute or chronic GvHD or oral manifestation of GvHD.…”

Section: Stimulated Saliva Flow Rates and Associations Of Hyposalivmentioning

confidence: 73%

“…Nonetheless, this study also suggests that the higher risk of death in the HSCT recipients with hyposalivation may actually explain some of this improvement observed, as hyposalivation (SSFR ≤ 0.7 mL/min) pre‐HSCT was significantly more common among the deceased, compared with the survivors. Thus, the former studies may exaggerate the regeneration potential of salivary tissues . Nonetheless, in our previous study, hyposalivation and persisting sicca symptoms were observed to be relatively common several years post‐HSCT …”

Section: Discussionmentioning

confidence: 87%

“…Reasons for hyposalivation in HSCT recipients are likely multifactorial. The conditioning regimen before HSCT can potentially affect salivary glands, particularly if TBI is used . Additionally, salivary glands are commonly affected by Graft vs Host Disease (GvHD).…”

Section: Introductionmentioning

confidence: 99%

“…The conditioning regimen before HSCT can potentially affect salivary glands, particularly if TBI is used. 3,27 Additionally, salivary glands are commonly affected by Graft vs Host Disease (GvHD). In GvHD, the infiltrating T-lymphocytes cause cytotoxicity in the salivary glands and reduce the secretion of saliva.…”

mentioning

confidence: 99%

“…13 However, in our previous study, use of medications could not explain hyposalivation in HSCT recipients. 27,28 Several current guidelines support dental screening and elimination of potential oral foci before HSCT as the HSCT treatment includes strong immunosuppression predisposing recipients to severe infection complications. 3,9,11,29 It has been estimated that 1.8 of every 1000 deaths could be prevented with dental treatment before HSCT.…”

mentioning

confidence: 99%

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Common oral diseases, hyposalivation and survival post‐HSCT, a longitudinal study

Uutela

Passweg

Gerull

et al. 2019

European J of Haematology

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Objectives Haematopoietic stem cell transplantation (HSCT) recipients are at risk of side effects within the oral cavity. The purpose of this study was to examine progression of common oral diseases and hyposalivation and their associations with survival in allogeneic HSCT recipients. Methods Two hundred and sixty nine adult HSCT recipients treated with HSCT between 2008 and 2016 were included in this study. The associations of caries, decayed, missing, filled teeth (DMFT) index, radiological attachment loss and stimulated salivary flow rate with 6‐month survival and the progression of the oral disorders within 2 years were examined. Results Forty HSCT recipients (14.8%) deceased within 6 months post‐HSCT. Among the deceased recipients, hyposalivation and caries were more common pre‐HSCT than in recipients who survived over 6 months (P < 0.05). HSCT recipients with hyposalivation pre‐HSCT had higher risk of death (HR: 1.90, 95% CI:1.00‐3.60; P = 0.044) within 6 months post‐HSCT compared with recipients without hyposalivation. Hyposalivation pre‐HSCT was associated with a higher DMFT index score (P < 0.05) and a smaller number of teeth (P < 0.005) 24 months post‐HSCT in comparison with those without hyposalivation. Conclusions Hyposalivation and caries were associated with a lower rate of survival in HSCT recipients. Additionally, hyposalivation predisposed to deterioration of oral health post‐HSCT.

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Section: Stimulated Saliva Flow Rates and Associations Of Hyposalivmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Common oral diseases, hyposalivation and survival post‐HSCT, a longitudinal study

Uutela

Passweg

Gerull

et al. 2019

European J of Haematology

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Oral disorders in patients with newly diagnosed haematological diseases

et al. 2020

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The effect of conditioning regimen and prescribed medications on hyposalivation in haematopoietic cell transplantation (HCT) patients: an 18-month prospective longitudinal study

Bulthuis,

van Gennip,

Thomas

et al. 2023

Clin Oral Invest

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Objectives Haematopoietic cell transplantation (HCT) preceded by a conditioning regimen is an established treatment option for (non)malignant haematologic disorders. We aim to describe the development of hyposalivation over time in HCT recipients, and determine risk indicators. Materials and methods A multi-centre prospective longitudinal observational study was conducted. Unstimulated (UWS) and stimulated (SWS) whole saliva was collected before HCT, early post-HCT, and after 3, 6, 12, and 18 months. The effect of type of transplantation (allogeneic vs autologous) and intensity (full vs reduced) of the conditioning regimen on hyposalivation (UWS < 0.2 mL/min; SWS < 0.7 mL/min) was explored. Results A total of 125 HCT recipients were included. More than half of the patients had hyposalivation early post-HCT; a quarter still had hyposalivation after 12 months. The conditioning intensity was a risk indicator in the development of hyposalivation of both UWS (OR: 3.9, 95% CI: 1.6–10.6) and SWS (OR: 8.2, 95% CI: 2.9–24.6). After 3 and 12 months, this effect was not statistically significant anymore. Conclusions Hyposalivation affects the majority of patients early post-HCT. The conditioning intensity and the type of transplantation were significant risk indicators in the development of hyposalivation. The number of prescribed medications, total body irradiation as part of the conditioning regimen and oral mucosal graft-versus-host disease did not influence hyposalivation significantly. Clinical relevance Because of the high prevalence of hyposalivation, HCT recipients will have an increased risk of oral complications. It might be reasonable to plan additional check-ups in the dental practice and consider additional preventive strategies.

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Determinants of stimulated salivary flow among haematopoietic stem cell transplantation recipients

Abstract: All HSCT recipients should be considered to be at high risk of hyposalivation and consequent oral diseases, and they should be treated accordingly.

Cited by 10 publications

References 19 publications

Common oral diseases, hyposalivation and survival post‐HSCT, a longitudinal study

Common oral diseases, hyposalivation and survival post‐HSCT, a longitudinal study

Oral disorders in patients with newly diagnosed haematological diseases

The effect of conditioning regimen and prescribed medications on hyposalivation in haematopoietic cell transplantation (HCT) patients: an 18-month prospective longitudinal study

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