Taste disorders and oral evaluation in patients undergoing allogeneic hematopoietic SCT

Abstract

The aim of this study was to evaluate taste perception, salivary flow rate and oral pathologies in three different groups of patients undergoing hematopoietic SCT (HSCT) classified according to time post transplant. Group I (n ¼ 20) up to 150 days after HSCT, group II (n ¼ 20) between 151 and 1095 days and group III (n ¼ 21) more than 1095 days. Taste acuity was measured by four basic tastes of four solutions, in three concentrations (M): NaCl, sucrose, citric acid and caffeine. Patients classified flavors as sweet, sour, salty, bitter and without flavor. The intensity was considered high, medium and low. Unstimulated saliva was collected and salivary flow rates (ml/min) were determined. Of 61 patients, 31 had chronic GVHD. For the sweet solution, the high and low concentrations represented a challenge for those patients. No patients were sensitive to the low concentration of caffeine solution (P ¼ 0.05). Saliva flow rate was diminished in 10 of 61 (16%) patients and hyposalivation was more intense in groups II/III (P ¼ 0.007). There was no correlation between taste dysfunction and oral chronic GVHD. The results indicated taste alterations only for the sweet and salty tastes even in patients up to 3 years after HSCT and may not correlate with oral chronic GVHD and with hyposalivation.

Taste and smell dysfunction in childhood cancer survivors

“…Patients who have received radiation therapy for head and neck cancer and those who have undergone a Hematopoietic Stem Cell Transplant (HSCT) demonstrate taste dysfunction, after their cancer treatment, up to seven and three years respectively. [11,13] Survivors of childhood cancer have been shown to have poor dietary habits [14][15][16] and preferences for high fat foods [17]. In the general population, those with a documented taste or smell dysfunction can alter their food intake, either by compensating for the lack of flavour in foods with an increase in intake, or decreasing their intake due to a lack of enjoyment of the food [18,9].…”

“…This occurs due to an alteration in the structure of the receptors or a decrease in the number of normal receptor cells [10]. Long-term taste and smell dysfunction has been documented in the adult oncology population [11][12]. Patients who have received radiation therapy for head and neck cancer and those who have undergone a Hematopoietic Stem Cell Transplant (HSCT) demonstrate taste dysfunction, after their cancer treatment, up to seven and three years respectively.…”

“…Some studies have suggested that taste dysfunction continues well after treatment completion [11][12] but this is the first study to assess this in a cohort of survivors of childhood cancer. There are wide variations in the prevalence rates of taste dysfunction in the general population.…”

Oral chronic graft-versus-host disease: A short review

“…The oral cavity is frequently involved, as the second most common site involved after skin due to HSCT, and oral manifestations occuring in 25 -90% of all cGVHD patients, often coexisting with cutaneous, hepatic or ocular cGVHD [2,7,9,[12][13][14][15][16]. It can be characterized as mucosal, salivary or sclerotic in nature, similary to several autoimmune conditions including Sjögren syndrome, oral lichen planus and scleroderma both clinical and histopathological presentation [12,13].…”

“…This disease is mediated by autoreactive T lymphocytes that infiltrate and attack various target organs and tissues, including oral mucosa and salivary glands, leading to salivary hypofunction and oral damage [7,9].…”