Abstract
Purpose
To assess magnitude and characteristics of changes in chemosensory function and quality of life (QOL) for patients receiving hematopoietic stem cell transplantation (HSCT).
Methods
Patients (aged 18 years and above) scheduled to undergo HSCT at the Seattle Cancer Care Alliance were tested for chemosensory function at three time points: pre-transplant (baseline), 30 ± 5 days (day 30), and 80 ± 5 days (day 80) post-HSCT. Gustatory function was assessed following procedures developed at the Monell-Jefferson Taste and Smell Clinic. Olfactory testing was conducted using the National Institute of Health Toolbox Odor Identification test. QOL was also assessed.
Results
Twenty-nine patients were enrolled in the study between August 2014 and March 2015. Twenty-three patients were included in the analysis, with 16 tested at all three time points (baseline, day 30, and day 80). The primary finding is decreased taste sensitivity for 0.32 M NaCl, 0.0056 M citric acid, and 0.018 M citric acid on day 30 following HSCT. Increased taste sensitivity for 0.32 M sucrose at day 30 was also observed. Taste sensitivity largely recovered by day 80. Olfactory identification scores were unchanged from baseline to day 30. QOL was reduced at day 30 but was restored to an acceptable level of functioning and symptoms by day 80. However, some areas remain impaired.
Conclusions
Alterations in taste perception were confirmed in the early post-transplant period. This was largely resolved within 2.5 months. No obvious impairments were observed in olfactory function. QOL improved by day 80, though some oral symptoms lingered.
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References
Copelan EA (2006) Hematopoietic stem-cell transplantation. N Engl J Med 354:1813–1826
Hamadani M, Mohty M, Kharfan-Dabaja M (2011) Reduced intensity conditioning allogeneic HCT in adults with acute myeloid leukemia. Cancer Control 18(4):237–245
Gratwohl A, Baldomero H, Aljurf M, Pasquini MC, Bouzas LF, Yoshimi A, Szer J, Lipton J, Schwendener A, Gratwohl M, Frauendorfer K, Niederwieser D, Horowitz M, Kodera Y, Worldwide Network of Blood and Marrow Transplantation (2010) Hematopoietic stem cell transplantation: a global perspective. J Am Med Assoc 303:1617–1162
Epstein JB, Phillips N, Parry J, Epstein MS, Nevill T, Stevenson-Moore P (2002) Quality of life, taste, olfactory and oral function following high-dose chemotherapy and allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 30:785–792
McIssac T (2008) Chemosensory dysfunction in advanced cancer patients. MS. Thesis. University of Alberta: Canada
Marinone MG, Rizzoni D, Ferremi P, Rossi G, Izzi T, Brusotti C (1991) Late taste disorders in bone marrow transplantation: clinical evaluation with taste solutions in autologous and allogeneic bone marrow recipients. Haematologica 76:519–522
Hull KM, Kerridge I, Schifter M (2012) Long-term oral complications of allogeneic haematopoietic SCT. Bone Marrow Transplant 47(2):265–270
Lenssen P, Sherry MA, Cheney CL, Nims JW, Sullivan KM, Stern JM, Moe G, Aker SN (1990) Prevalence of nutrition-related problems among long-term survivors of allogeneic marrow transplantation. J Am Diet Assoc 90:835–842
Iestra JA, Fibbe WE, Zwinderman AH, Van Staveren WA, Kromhout D (2002) Body weight recovery, eating difficulties and compliance with dietary advice in the first year after stem cell transplantation: a prospective study. Bone Marrow Transplant 29:417–424
Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:3665–3376
Groenvold M, Klee MC, Sprangers MA, Aaronson NK (1997) Validation of the EORTC QLQ-C30 quality of life questionnaire through combined qualitative and quantitative assessment of patient-observer agreement. J Clin Epidemiol 50:441–450
Hjermstad MJ, Fossa SD, Bjordal K, Kaasa S (1995) Test/retest study of the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire. J Clin Oncol 13:1249–1254
Bjordal K, Hammerlid E, Ahlner-Elmqvist M, de Graeff A, Boysen M, Evensen JF, Biörklund A, de Leeuw JR, Fayers PM, Jannert M, Westin T, Kaasa S (1999) Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35. J Clin Oncol 14:1008–1019
Dalton P, Doty RL, Murphy C, Frank R, Hoffman HJ, Maute C, Kallen MA, Slotkin J (2013) Olfactory assessment using the NIH Toolbox. Neurology 80(11 Suppl 3):S32–S36. https://doi.org/10.1212/WNL.0b013e3182872eb4
Pribitkin E, Rosenthal MD, Cowart BJ (2003) Prevalence and causes of severe taste loss in a chemosensory clinic population. Ann Otol Rhino Laryngol 112(11):971–978
Bartoshuk LM (1978) The psychophysics of taste. Am J Clin Nutr 31:1068–1077
Andersson I, Ahlberg K, Stockelberg D, Brune M, Persson L-O (2009) Health-related quality of life in patients undergoing allogenic cell transplantation after reduced intensity conditioning versus myeloablative conditioning. Cancer Nurs 32(4):325–334
Hovan AJ, Williams PM, Stevenson-Moore P, Wahlin YB, Ohrn KE, Elting LS et al (2010) A systemic review of dysgeusia induced by cancer therapies. Support Care Cancer 18(8):1081–1087
Mattsson T, Arvidson K, Heimdahl A, Ljungman P, Dahllof G, Ringden O (1992) Alterations in taste acuity associated with allogeneic bone marrow transplantation. J Oral Pathol Med 21:33–37
Boer CC, Correa ME, Miranda EC, de Souza CA (2010) Taste disorders and oral evaluation in patients undergoing allogeneic hematopoietic SCT. Bone Marrow Transplant 45(4):705–711
Doty RL, Bromley SM (2004) Effects of drugs on olfaction and taste. Otolaryngol Clin N Am 37(6):1229–1254. https://doi.org/10.1016/j.otc.2004.05.002
Zervakis J, Graham BG, Schiffman SS (2000) Taste effects of lingual application of cardiovascular medications. Physiol Behav 68(3):405–413
Fernando I, Patel T, Billingham L et al (1995) The effect of head and neck irradiation on taste dysfunction: a prospective study. Clin Oncol 7:173–178
Fábián TK, Beck A, Fejérdy P, Hermann P, Fábián G (2015) Molecular mechanisms of taste recognition: considerations about the role of saliva. Int J Mol Sci 16(3):5945–5974. https://doi.org/10.3390/ijms16035945
Vissink A, Burlage FR, Spijkervet FK, Jansma J, Coppes RP (2003) Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med 14:213–225
Bernstein IL (1985) Learned food aversions in the progression of cancer and its treatment. Ann N Y Acad Sci 443:365–380
Acknowledgements
This work was supported by funding from the University of Washington Department of Oral Medicine, the Institute for Translational Health Sciences TL1 TR000422 (S. Soliman), and the Washington Dental Service Endowed Professorship (S. Coldwell). The authors would like to thank Sumia Dakhil for her assistance with the data entry.
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Abasaeed, R., Coldwell, S.E., Lloid, M.E. et al. Chemosensory changes and quality of life in patients undergoing hematopoietic stem cell transplantation. Support Care Cancer 26, 3553–3561 (2018). https://doi.org/10.1007/s00520-018-4200-7
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DOI: https://doi.org/10.1007/s00520-018-4200-7