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Dequae CGR, Raber-Durlacher JE, Epstein JB, de Vries R, Laheij AMGA. Taste alterations after hematopoietic cell transplantation: a scoping review. Support Care Cancer 2024; 32:687. [PMID: 39320564 PMCID: PMC11424654 DOI: 10.1007/s00520-024-08900-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 09/23/2024] [Indexed: 09/26/2024]
Abstract
PURPOSE This review aimed to evaluate the prevalence and characteristics of dysgeusia after hematopoietic cell transplantation (HCT). METHODS A literature search (in PubMed, Embase.com and Web of Science) for clinical studies evaluating taste before and after HCT was performed up to June 22, 2023, in collaboration with a medical information specialist. After title and abstract review (N = 807) followed by full-text review (N = 61), articles that met the inclusion criteria were summarized in a table and synthesized narratively. RESULTS 11 articles were analyzed in this review. All studies had a prospective design and patient populations included children (N = 3) and adults (N = 8) undergoing allogeneic or autologous HCT. Taste was assessed objectively (N = 6) and/or subjectively (N = 8) between baseline and 12 months after HCT. Before HCT, the self-reported (0-31%) and objective (2.4-10%) prevalence of dysgeusia was low. During the neutropenic phase, self-reported (20-100%) and objective (21.4%) dysgeusia was highest. In the post-engraftment period, the self-reported (18%) and objective (0-33%) prevalence of dysgeusia decreased. Different taste qualities were assessed in six studies including salt, sour, bitter, sweet, and umami. CONCLUSIONS Some patients undergoing HCT experience dysgeusia prior to treatment. During the neutropenic phase, they had highest complaints, with recovery occurring in the post-engraftment period. All basic tastes, except bitter, were affected. Umami and salt were most affected during treatment. These findings have implications for patient management.
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Affiliation(s)
- Caroline G R Dequae
- Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 HV, Amsterdam, The Netherlands
| | - Judith E Raber-Durlacher
- Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 HV, Amsterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Joel B Epstein
- Dental Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA and Cedars-Sinai Medical System, Los Angeles, CA, USA
| | - Ralph de Vries
- Medical Library, VU University, Amsterdam, The Netherlands
| | - Alexa M G A Laheij
- Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 HV, Amsterdam, The Netherlands.
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
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López-Plaza B, Álvarez-Mercado AI, Arcos-Castellanos L, Plaza-Diaz J, Ruiz-Ojeda FJ, Brandimonte-Hernández M, Feliú-Batlle J, Hummel T, Gil Á, Palma-Milla S. Efficacy and Safety of Habitual Consumption of a Food Supplement Containing Miraculin in Malnourished Cancer Patients: The CLINMIR Pilot Study. Nutrients 2024; 16:1905. [PMID: 38931260 PMCID: PMC11207068 DOI: 10.3390/nu16121905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/13/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Taste disorders (TDs) are common among systemically treated cancer patients and negatively impact their nutritional status and quality of life. The novel food approved by the European Commission (EFSA), dried miracle berries (DMB), contains the natural taste-modifying protein miraculin. DMB, also available as a supplement, has emerged as a possible alternative treatment for TDs. The present study aimed to evaluate the efficacy and safety of habitual DMB consumption in malnourished cancer patients undergoing active treatment. An exploratory clinical trial was carried out in which 31 cancer patients were randomized into three arms [standard dose of DMB (150 mg DMB/tablet), high dose of DMB (300 mg DMB/tablet) or placebo (300 mg freeze-dried strawberry)] for three months. Patients consumed a DMB tablet or placebo daily before each main meal (breakfast, lunch, and dinner). Throughout the five main visits, electrochemical taste perception, nutritional status, dietary intake, quality of life and the fatty acid profile of erythrocytes were evaluated. Patients consuming a standard dose of DMB exhibited improved taste acuity over time (% change right/left side: -52.8 ± 38.5/-58.7 ± 69.2%) and salty taste perception (2.29 ± 1.25 vs. high dose: 2.17 ± 1.84 vs. placebo: 1.57 ± 1.51 points, p < 0.05). They also had higher energy intake (p = 0.075) and covered better energy expenditure (107 ± 19%). The quality of life evaluated by symptom scales improved in patients receiving the standard dose of DMB (constipation, p = 0.048). The levels of arachidonic (13.1 ± 1.8; 14.0 ± 2.8, 12.0 ± 2.0%; p = 0.004) and docosahexaenoic (4.4 ± 1.7; 4.1 ± 1.0; 3.9 ± 1.6%; p = 0.014) acids in erythrocytes increased over time after DMB intake. The standard dose of DMB increased fat-free mass vs. placebo (47.4 ± 9.3 vs. 44.1 ± 4.7 kg, p = 0.007). Importantly, habitual patients with DMB did not experience any adverse events, and metabolic parameters remained stable and within normal ranges. In conclusion, habitual consumption of a standard 150 mg dose of DMB improves electrochemical food perception, nutritional status (energy intake, fat quantity and quality, fat-free mass), and quality of life in malnourished cancer patients receiving antineoplastic treatment. Additionally, DMB consumption appears to be safe, with no changes in major biochemical parameters associated with health status. Clinical trial registered (NCT05486260).
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Affiliation(s)
- Bricia López-Plaza
- Food, Nutrition and Health Platform, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain; (L.A.-C.); (S.P.-M.)
- Medicine Department, Faculty of Medicine, Complutense University of Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain
| | - Ana Isabel Álvarez-Mercado
- Department of Pharmacology, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain; (J.P.-D.); (F.J.R.-O.); (Á.G.)
- Institute of Nutrition and Food Technology “José Mataix”, Centre of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, Armilla, 18016 Granada, Spain;
| | - Lucía Arcos-Castellanos
- Food, Nutrition and Health Platform, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain; (L.A.-C.); (S.P.-M.)
| | - Julio Plaza-Diaz
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain; (J.P.-D.); (F.J.R.-O.); (Á.G.)
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Francisco Javier Ruiz-Ojeda
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain; (J.P.-D.); (F.J.R.-O.); (Á.G.)
- Institute of Nutrition and Food Technology “José Mataix”, Centre of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, Armilla, 18016 Granada, Spain;
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marco Brandimonte-Hernández
- Institute of Nutrition and Food Technology “José Mataix”, Centre of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, Armilla, 18016 Granada, Spain;
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
| | - Jaime Feliú-Batlle
- Oncology Department, Hospital La Paz Institute for Health Research—IdiPAZ, Hospital Universitario La Paz, 28029 Madrid, Spain;
- CIBERONC (CIBER Cancer), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Medicine Department, Faculty of Medicine, Autonomous University of Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany;
| | - Ángel Gil
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain; (J.P.-D.); (F.J.R.-O.); (Á.G.)
- Institute of Nutrition and Food Technology “José Mataix”, Centre of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, Armilla, 18016 Granada, Spain;
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Samara Palma-Milla
- Food, Nutrition and Health Platform, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain; (L.A.-C.); (S.P.-M.)
- Medicine Department, Faculty of Medicine, Autonomous University of Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain
- Nutrition Department, Hospital University La Paz, 28046 Madrid, Spain
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Tharakan T, Piccirillo JF, Miller B, Reed DR, Kallogjeri D, Paniello R, Puram SV, Jackson RS. Acute Taste Dysfunction in Oropharyngeal Cancer Patients after Transoral Robotic Surgery. Laryngoscope 2023; 133:3520-3528. [PMID: 37551882 PMCID: PMC10843268 DOI: 10.1002/lary.30939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/23/2023] [Accepted: 07/17/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES To compare taste changes after transoral robotic surgery (TORS) to taste changes in healthy controls. METHODS Oropharyngeal cancer patients receiving TORS and healthy controls were recruited. Participants underwent posterolateral and whole-mouth psychophysical taste testing (identification, intensity, and hedonics) at baseline and at 2 weeks postoperatively (patients) or follow-up (controls). Surgeons reported suspension time and glossopharyngeal nerve injury (GNI) based on the identification and sacrifice of the nerve. A Clinical Global Impression (CGI) of taste symptoms was completed at each session ("My sense of taste bothers me" on a 5-point scale from Never [1] to Always [5]). A taste disorder (TD) was a CGI of 3 (Sometimes) or worse. Within-subject changes in CGI and psychophysical scores were computed. "Worsened taste" was a CGI increase by ≥1 point at follow-up. RESULTS Of 69 participants, most (33/37 tumor, 31/32 controls) had normal baseline taste (CGI < 3). 14/33 (42%) TORS patients and no controls developed new TDs at follow-up. More smokers (7/9) had worsened taste than nonsmokers (19/60, difference = 46% [95% CI 16%-76%]). More patients without GNI (6/22) than with GNI (0/15) had postoperative phantogeusia (difference = 27% [95% CI 9-45%]). Tumor-ipsilateral taste identification (TI) decreased more in patients (-11.3%) than controls (0.8%, difference = 12.2% [95% CI 5.0-19.3%]). Suspension time was not associated with worsened taste symptoms or psychophysical changes. CONCLUSIONS Patient-reported taste changes after TORS are frequent. Compared to healthy controls, TORS patients have decreased tumor-ipsilateral TI. Suspension time and GNI are unlikely to cause symptomatic TDs. Further investigations of the etiology and long-term symptom burden of TORS-associated TDs will aid in the management of oropharyngeal cancer patients. LEVEL OF EVIDENCE 3 (non-randomized controlled cohort study) Laryngoscope, 133:3520-3528, 2023.
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Affiliation(s)
- Theresa Tharakan
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Jay F. Piccirillo
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Brevin Miller
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
- School of Medicine, University of Missouri Kansas City, Kansas City, MO
| | | | - Dorina Kallogjeri
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Randall Paniello
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Sidharth V. Puram
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
- Department of Genetics, Washington University School of Medicine, St Louis, MO
| | - Ryan S. Jackson
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
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Bulthuis MS, van Gennip LLA, Bronkhorst EM, Blijlevens NMA, Huysmans MCDNJM, van Leeuwen SJM, Thomas RZ. The effect of hematopoietic stem cell transplantation on patient-reported subjective oral dryness: a systematic review focusing on prevalence, severity and distress. Support Care Cancer 2023; 31:449. [PMID: 37421511 PMCID: PMC10329604 DOI: 10.1007/s00520-023-07921-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/30/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE The aim of the present systematic review is to assess the prevalence and severity of and distress caused by xerostomia over time in adult hematopoietic stem cell transplantation (HSCT) recipients. METHODS PubMed, Embase, and the Cochrane Library were searched for papers published between January 2000 and May 2022. Clinical studies were included if patient-reported subjective oral dryness was reported in adult autologous or allogeneic HSCT recipients. Risk of bias was assessed according to a quality grading strategy published by the oral care study group of the MASCC/ISOO, resulting in a score between 0 (highest risk of bias) and 10 (lowest risk of bias). Separate analysis focused on autologous HSCT recipients, allogeneic HSCT recipients receiving a myeloablative conditioning (MAC), and those receiving a reduced intensity conditioning (RIC). RESULTS Searches yielded 1792 unique records; 22 studies met the inclusion criteria. The quality scores ranged between 1 and 7, with a median score of 4. The prevalence, severity, and distress of xerostomia increased shortly after HSCT. Severity of xerostomia in allogeneic MAC recipients was higher compared to allogeneic RIC recipients 2-5 months post-HSCT (mean difference: 18 points on 0-100 scale, 95% CI: 9-27); after 1-2 years, there was no significant difference anymore. CONCLUSION The prevalence of xerostomia in HSCT recipients is high in comparison to the general population. The severity of complaints is raised during the first year post-HSCT. The intensity of the conditioning plays a key role in the short-term development of xerostomia, while factors affecting the recovery in the long term remain largely unknown.
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Affiliation(s)
- Marjolein S Bulthuis
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Lucky L A van Gennip
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ewald M Bronkhorst
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Renske Z Thomas
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
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Boor M, Raber-Durlacher JE, Hazenberg MD, Rozema FR, Laheij AMGA. Taste and smell disturbances in patients with chronic oral graft vs. host disease: An observational study. FRONTIERS IN ORAL HEALTH 2022; 3:934607. [PMID: 36160117 PMCID: PMC9500145 DOI: 10.3389/froh.2022.934607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundA common complication of allogeneic hematopoietic stem cell transplantation (alloHSCT) is chronic oral graft vs. host disease (cGvHD). Oral cGvHD may present as mucosal lesions, salivary gland dysfunction, and trismus. Moreover, taste and smell ability may be affected, but the prevalence, nature and severity of altered taste and smell function, and their impact on quality of life (QoL) are understudied.AimTo identify the prevalence, nature, and severity of taste and smell disturbances, their impact on QoL and to assess whether altered taste/smell ability is associated with oral mucosal cGvHD or hyposalivation.Materials and methodsAlloHSCT recipients at least 100 days post-HSCT and referred for oral cGvHD-related oral complaints were eligible for participation in this cross-sectional study. Manifestations of oral mucosal cGvHD were scored, the (un)stimulated salivary flow was measured, and objective taste and smell ability was evaluated. Subjective taste and smell alterations, and overall and oral health (OH)-related QoL were assessed.ResultsIn total, 45 patients were included, of which objective reduced taste ability (hypogeusia) was identified in 68.9%; 28.9% had reduced smell ability and 11.1% had complete loss of smell. Nevertheless, only 31.1% of patients reported severe taste alterations and 22% reported moderate taste alterations indicating that not all the patients were aware of their altered taste sense. Taste/smell disturbances were not related to oral mucosal cGvHD or hyposalivation. Most alloHSCT recipients reported a decreased OH-related QoL. However, a relation between taste/smell ability and global or OH-related QoL could not be identified.ConclusionTaste and smell disturbances are prevalent among alloHSCT recipients. Most patients reported a decreased OH-related QoL, but the specific impact of taste and smell disturbances remains to be elucidated.
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Affiliation(s)
- Marlou Boor
- Department of Oral Medicine, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- *Correspondence: Marlou Boor
| | - Judith E. Raber-Durlacher
- Department of Oral Medicine, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Oral Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Mette D. Hazenberg
- Department of Hematology Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Frederik R. Rozema
- Department of Oral Medicine, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Oral Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Alexa M. G. A. Laheij
- Department of Oral Medicine, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Oral Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Preventive Dentistry, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Marques ADCB, Machado CAM, Tomim DH, Guimarães PRB, Felix JVC, Kalinke LP. Assessment of quality of life three years from hematopoietic stem cell transplant. Rev Esc Enferm USP 2021; 55:e20200270. [PMID: 34477195 DOI: 10.1590/1980-220x-reeusp-2020-0270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 05/06/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the domains of quality of life related to hematologic cancer patient health in the first three years from autologous and allogeneic hematopoietic stem cell transplantation. METHOD A prospective cohort from September 2013 to February 2019 at a reference service in Latin America with 55 patients. The instruments Quality of Life Questionnaire Core C30 and Functional Assessment Cancer Therapy - Bone Marrow Transplantation were used. For data analysis, Generalized Linear Mixed Model was used. RESULTS The domains global and overall quality of life presented the lowest scores in the pancytopenia phase: 59.3 and 91.4 in autologous, 55.3 and 90.3 in allogeneic. The mixed method analysis has shown that there was a significant change in scores between the phases throughout the treatment (p< 0.05). CONCLUSION Health-related quality of life presented significant changes in the domains between the phases throughout time. Understanding these results enables nursing interventions directed at the domains which were damaged during treatment.
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Epstein JB, Villines D, Epstein GL, Smutzer G. Oral examination findings, taste and smell testing during and following head and neck cancer therapy. Support Care Cancer 2020; 28:4305-4311. [PMID: 31912362 DOI: 10.1007/s00520-019-05232-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 12/05/2019] [Indexed: 01/10/2023]
Abstract
PURPOSE Diet and nutrition are critical in health and disease and are highly impacted by the presence and treatment for head and neck cancer (HNC). The purpose of this paper is to present oral examination findings and taste and smell test results in patients during and following HNC. METHODS Patients with HNC were evaluated during and following radiation therapy with/without chemotherapy. Oral examination findings including mucositis, saliva, oral hygiene (plaque levels, gingivitis), and taste and smell testing was completed on all subjects. NCI Common Terminology Criteria for Adverse Events (CTCAE) 4.0, and the Scale of Subjective Total Taste Acuity (STTA) were used to provide patient report of symptoms. RESULTS Mucositis and pain affected oral diet during therapy and improved in follow-up. Weight loss of 5% during and 12% following treatment was identified. Tobacco use was associated with increased severity of mucositis and increased weight loss. The subjects maintained excellent oral hygiene as reflected in plaque levels and gingivitis. Spicy/pungent perception was the most strongly disliked of testing stimuli. Umami and fat taste perception were reported of highest intensity during HNC treatment and rated as moderate in intensity after treatment. These results suggest improvement in these taste functions over time following treatment. Salt taste was of high intensity and associated with strong dislike in follow-up. CONCLUSIONS In HNC patients, oral status and taste change occurs throughout the cancer trajectory and represent potential concerns in cancer survivorship. Taste change (as evaluated by taste testing) occurred in all HNC patients, whereas olfactory changes occurred in 30% of cases. Management of oral changes and symptoms should be considered in all HNC patients in addition to dietary and nutritional guidance in patient care to promote oral intake. Continuing study of taste changes may further define this problem and support dietary and nutritional guidance and product development.
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Affiliation(s)
- Joel B Epstein
- , Beverly Hills, CA, USA. .,Cedars-Sinai Medical Center, Los Angeles, CA, USA. .,City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
| | - Dana Villines
- Department of Research, Advocate Health Care, Chicago, IL, USA
| | | | - Gregory Smutzer
- Department of Biology, Temple University, Philadelphia, PA, 19122, USA
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Ferreira MH, Mello Bezinelli L, de Paula Eduardo F, Lopes RM, Pereira AZ, Hamerschlack N, Corrêa L. Association of oral toxicity and taste changes during hematopoietic stem cell transplantation: a preliminary study. Support Care Cancer 2019; 28:1277-1287. [PMID: 31236700 DOI: 10.1007/s00520-019-04922-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 06/05/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this study was to characterize the taste changes and taste bud atrophy observed in the period of neutropenia of HCT and to determine the influence of transplantation toxicity on these changes. METHODS Autologous and allogeneic HCT patients (n = 51) were selected to perform taste acuity tests prior to conditioning (T0) and during neutropenia (T1). The frequency and time duration of oral mucositis, presence of tongue depapillation, and salivary flow rate were also evaluated. Quality of life was assessed using specific questionnaires. RESULTS We observed a significant increase in hypogeusia (66.6%, p = 0.001) and dysgeusia (21.4%, p = 0.013) at T1, compared with T0. Bitter taste was the most altered, mainly when the patient underwent conditioning with melphalan (OR = 4.47, p = 0.049). Prolonged oral mucositis (≥ 8 days) (OR = 5.62, p = 0.039) and autologous transplantation (OR = 4.08, p = 0.033) were predictive factors for tongue depapillation. Changes in sour taste (OR = 10.70, p = 0.045) and reduced salivary flow (OR = 21.00, p = 0.013) were associated to body weight loss at T1. Taste changes significantly reduced the quality of life at T1, compared with T0. CONCLUSIONS Frequency of hypogeusia was high in the neutropenia period of the HCT. None of the taste changes was determined by oral mucositis, tongue depapillation, or reduced salivary flow, but melphalan conditioning reduced the bitter taste sensation. Loss of body weight and poor quality of life were associated with taste changes and reduced salivary flow. Further studies are necessary to elucidate this association and the risk factors for taste changes in HCT.
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Affiliation(s)
- Mariana Henriques Ferreira
- Bone Marrow Transplantation Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
- General Pathology Department, School of Dentistry, University of São Paulo, 2227 Cidade Universitária, São Paulo, 05508-000, Brazil
| | | | | | - Roberta Marques Lopes
- Bone Marrow Transplantation Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Andrea Z Pereira
- Bone Marrow Transplantation Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Nelson Hamerschlack
- Bone Marrow Transplantation Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Luciana Corrêa
- General Pathology Department, School of Dentistry, University of São Paulo, 2227 Cidade Universitária, São Paulo, 05508-000, Brazil.
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Epstein JB, de Andrade e Silva SM, Epstein GL, Leal JHS, Barasch A, Smutzer G. Taste disorders following cancer treatment: report of a case series. Support Care Cancer 2019; 27:4587-4595. [DOI: 10.1007/s00520-019-04758-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 03/18/2019] [Indexed: 11/29/2022]
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