Major salivary gland damage in allogeneic hematopoietic progenitor cell transplantation assessed by scintigraphic methods

Abstract

Salivary gland dysfunction is a common sequela of hematopoietic progenitor cell transplantation (HPCT). The investigation of major salivary gland dysfunction with sodium pertechnetate scintigraphy is a non-invasive method that provides images of the parotid and submandibular glands. In this prospective trial, 20 HPCT patients were submitted to scintigraphic study with 99m Tcpertechenate and 67 Ga in order to evaluate the major salivary glands early involvement following HPCT. Major salivary glands were evaluated prior to HCPT as well as at Days þ 30, þ 60 and þ 100 post transplant. Major salivary glands uptake and clearance of 99m Tc-pertechenate results did not demonstrate any functional differences between pre-versus post transplant periods. Results of the 67 Ga scan revealed inflammatory infiltration following HPCT, primarily in submandibular glands, suggest a persistent involvement of major salivary glands up to Day þ 100 after HPCT. Bone Marrow Transplantation (2006) 37, 955-959.

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life

“…This is consistent with findings of other studies of unstimulated and stimulated whole saliva and stimulated parotid saliva in mixed pediatric/adolescent and adult populations [172][173][174]. However, one study examining unstimulated whole saliva flow rate did not find a difference from before hematopoietic stem cell transplantation compared to up to 3 months after treatment in a small adult population when the conditioning regimen consisted of high-dose chemotherapy only [175].…”

Taste disorders and oral evaluation in patients undergoing allogeneic hematopoietic SCT

“…Conditioning regimens can promote oral toxicity and also injure salivary glands. 22 Salivary damage could be observed in the scintigraphy of patients 100 days after HSCT and could be prompted by the presence of cGVHD.…”

Long-term oral complications of allogeneic haematopoietic SCT

“…Later changes are most often ascribed to cGVHD and clinically (and histologically) resemble the features of Sjo¨gren syndrome. 16 Extensive cGVHD involving the salivary glands results in destruction of secretory units, leading to a permanent and profound reduction in saliva production. 17 Reduced stimulated salivary flow, measured over 5 min, was the most consistently demonstrated adverse oral effect in this patient population, with 34% demonstrating some degree of salivary hypofunction.…”