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Association of oral toxicity and taste changes during hematopoietic stem cell transplantation: a preliminary study

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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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References

  1. Boer CC, Correa ME, Miranda EC, de Souza CA (2010) Taste disorders and oral evaluation in patients undergoing allogeneic hematopoietic SCT. Bone Marrow Transplant 45:705–711. https://doi.org/10.1038/bmt.2009.237

    Article  CAS  PubMed  Google Scholar 

  2. Abasaeed R, Coldwell SE, Lloid ME, Soliman SH, Macris PC, Schubert MM (2018) Chemosensory changes and quality of life in patients undergoing hematopoietic stem cell transplantation. Support Care Cancer 26:3553–3561. https://doi.org/10.1007/s00520-018-4200-7

    Article  PubMed  PubMed Central  Google Scholar 

  3. Barlow LA (2015) Progress and renewal in gustation: new insights into taste bud development. Development. 142:3620–3629. https://doi.org/10.1242/dev.120394

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Capra S, Ferguson M, Ried K (2001) Cancer: impact of nutrition intervention outcome--nutrition issues for patients. Nutrition 17:769–772

    Article  CAS  Google Scholar 

  5. 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

    Article  CAS  Google Scholar 

  6. Jager-Wittenaar H, Dijkstra PU, Vissink A, van der Laan BF, van Oort RP, Roodenburg JL (2007) Critical weight loss in head and neck cancer—prevalence and risk factors at diagnosis: an explorative study. Support Care Cancer 15:1045–1050

    Article  Google Scholar 

  7. van der Werf A, Rovithi M, Langius JAE, de van der Schueren MAE, Verheul HMW (2017) Insight in taste alterations during treatment with protein kinase inhibitors. Eur J Cancer 86:125–134. https://doi.org/10.1016/j.ejca.2017.09.006

    Article  CAS  PubMed  Google Scholar 

  8. Belqaid K, Tishelman C, Orrevall Y, Månsson-Brahme E, Bernhardson BM (2018) Dealing with taste and smell alterations—a qualitative interview study of people treated for lung cancer. PLoS One 23:e0191117. https://doi.org/10.1371/journal.pone.0191117

    Article  CAS  Google Scholar 

  9. Scordo M, Shah GL, Peled JU, Preston EV, Buchan ML, Epstein JB, Barasch A, Giralt SA (2018) Unlocking the complex flavors of dysgeusia after hematopoietic cell transplantation. Biol Blood Marrow Transplant 24:425–432. https://doi.org/10.1016/j.bbmt.2017.10.022

    Article  PubMed  Google Scholar 

  10. 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

    Article  CAS  Google Scholar 

  11. Rodgers C, Young A, Hockenberry M, Binder B, Symes L (2010) The meaning of adolescents’ eating experiences during bone marrow transplant recovery. J Pediatr Oncol Nurs 27:65–72. https://doi.org/10.1177/1043454209355984

    Article  PubMed  PubMed Central  Google Scholar 

  12. Cohen J, Laing DG, Wilkes FJ, Chan A, Gabriel M, Cohn RJ (2014) Taste and smell dysfunction in childhood cancer survivors. Appetite. 75:135–140. https://doi.org/10.1016/j.appet.2014.01.001

    Article  PubMed  Google Scholar 

  13. Majorana A, Amadori F, Bardellini E, Campus G, Conti G, Strohmenger L, Schumacher RF, Polimeni A (2015) Taste dysfunction in patients undergoing hematopoietic stem cell transplantation: clinical evaluation in children. Pediatr Transplant 19:571–575. https://doi.org/10.1111/petr.12535

    Article  PubMed  Google Scholar 

  14. de Paula Eduardo F, Bezinelli LM, da Graça Lopes RM, Nascimento Sobrinho JJ, Hamerschlak N, Correa L (2015) Efficacy of cryotherapy associated with laser therapy for decreasing severity of melphalan-induced oral mucositis during hematological stem-cell transplantation: a prospective clinical study. Hematol Oncol 33:152–158. https://doi.org/10.1002/hon.2133

    Article  CAS  PubMed  Google Scholar 

  15. Bezinelli LM, Eduardo FP, Neves VD, Correa L, Lopes RM, Michel-Crosato E, Hamerschlak N, Biazevic MG (2016) Quality of life related to oral mucositis of patients undergoing haematopoietic stem cell transplantation and receiving specialised oral care with low-level laser therapy: a prospective observational study. Eur J Cancer Care (Engl) 25:668–674

    Article  CAS  Google Scholar 

  16. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, Haes JCJM, Kaasa S, Klee M, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F (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 85:365–376

    Article  CAS  Google Scholar 

  17. Vartanian JG, Carvalho AL, Yueh B, Furia CL, Toyota J, McDowell JA, Weymuller EA Jr, Kowalski LP (2006) Brazilian-Portuguese validation of the University of Washington Quality of Life Questionnaire for patients with head and neck cancer. Head Neck 28:1115–1121

    Article  Google Scholar 

  18. Grulke N, Albani C, Bailer H (2012) Quality of life in patients before and after haematopoietic stem cell transplantation measured with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire QLQ-C30. Bone Marrow Transplant 47:473–482. https://doi.org/10.1038/bmt.2011.107

    Article  CAS  PubMed  Google Scholar 

  19. Silveira AP, Gonçalves J, Sequeira T, Ribeiro C, Lopes C, Monteiro E, Pimentel FL (2010) Patient reported outcomes in head and neck cancer: selecting instruments for quality of life integration in clinical protocols. Head Neck Oncol 31:32. https://doi.org/10.1186/1758-3284-2-32

    Article  Google Scholar 

  20. Hong JH, Omur-Ozbek P, Stanek BT, Dietrich AM, Duncan SE, Lee YW, Lesser G (2009) Taste and odor abnormalities in cancer patients. J Support Oncol 7:58–65

    PubMed  Google Scholar 

  21. Mattsson T, Arvidson K, Heimdahl A, Ljungman P, Dahllof G, Ringdén O (1992) Alterations in taste acuity associated with allogeneic bone marrow transplantation. J Oral Pathol Med 21:33–37

    Article  CAS  Google Scholar 

  22. Steinbach S, Hummel T, Böhner C, Berktold S, Hundt W, Kriner M, Heinrich P, Sommer H, Hanusch C, Prechtl A, Schmidt B, Bauerfeind I, Seck K, Jacobs VR, Schmalfeldt B, Harbeck N (2009) Qualitative and quantitative assessment of taste and smell changes in patients undergoing chemotherapy for breast cancer or gynecologic malignancies. J Clin Oncol 27:1899–1905. https://doi.org/10.1200/JCO.2008.19.2690

    Article  PubMed  Google Scholar 

  23. Schalk P, Kohl M, Herrmann HJ, Schwappacher R, Rimmele ME, Buettner A, Siebler J, Neurath MF, Zopf Y (2018) Influence of cancer and acute inflammatory disease on taste perception: a clinical pilot study. Support Care Cancer 26:843–851. https://doi.org/10.1007/s00520-017-3898-y

    Article  CAS  PubMed  Google Scholar 

  24. Skolin I, Wahlin YB, Broman DA, Koivisto Hursti UK, Vikström Larsson M, Hernell O (2006) Altered food intake and taste perception in children with cancer after start of chemotherapy: perspectives of children, parents and nurses. Support Care Cancer 14:369–378

    Article  Google Scholar 

  25. Onoda K, Hirai R, Takao K, Kokubun S, Ikeda M (2011) Patients with hypogeusia show changes in expression of T2R taste receptor genes in their tongues. Laryngoscope. 121:2592–2597. https://doi.org/10.1002/lary.22368

    Article  CAS  PubMed  Google Scholar 

  26. Feng P, Jyotaki M, Kim A, Chai J, Simon N, Zhou M, Bachmanov AA, Huang L, Wang H (2015) Regulation of bitter taste responses by tumor necrosis factor. Brain Behav Immun 49:32–42. https://doi.org/10.1016/j.bbi.2015.04.001

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Hovan AJ, Williams PM, Stevenson-Moore P, Wahlin YB, Ohrn KE, Elting LS et al (2010) A systematic review of dysgeusia induced by cancer therapies. Support Care Cancer 18:1081–1087. https://doi.org/10.1007/s00520-010-0902-1

    Article  PubMed  Google Scholar 

  28. IJpma I, Renken RJ, Ter Horst GJ, Reyners AK (2015) Metallic taste in cancer patients treated with chemotherapy. Cancer Treat Rev 41:179–186. https://doi.org/10.1016/j.ctrv.2014.11.006

    Article  CAS  PubMed  Google Scholar 

  29. Lilleby K, Garcia P, Gooley T, McDonnnell P, Taber R, Holmberg L, Maloney DG, Press OW, Bensinger W (2006) Prospective, randomized study of cryotherapy during administration of high-dose melphalan to decrease the severity and duration of oral mucositis in patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation. Bone Marrow Transplant 37:1031–1035

    Article  CAS  Google Scholar 

  30. Comeau TB, Epstein JB, Migas C (2001) Taste and smell dysfunction in patients receiving chemotherapy: a review of current knowledge. Support Care Cancer 9:575–580

    Article  CAS  Google Scholar 

  31. Tsutsumi R, Goda M, Fujimoto C, Kanno K, Nobe M, Kitamura Y, Abe K, Kawai M, Matsumoto H, Sakai T, Takeda N (2016) Effects of chemotherapy on gene expression of lingual taste receptors in patients with head and neck cancer. Laryngoscope. 126:E103–E109. https://doi.org/10.1002/lary.25679

    Article  CAS  PubMed  Google Scholar 

  32. Ovesen L, Hannibal J, Sørensen M (1991) Taste thresholds in patients with small-cell lung cancer. J Cancer Res Clin Oncol 117:70–72

    Article  CAS  Google Scholar 

  33. Bressan V, Stevanin S, Bianchi M, Aleo G, Bagnasco A, Sasso L (2016 Apr) The effects of swallowing disorders, dysgeusia, oral mucositis and xerostomia on nutritional status, oral intake and weight loss in head and neck cancer patients: a systematic review. Cancer Treat Rev 45:105–119

    Article  Google Scholar 

  34. Aoyama T, Imataki O, Mori K, Yoshitsugu K, Fukaya M, Okamura I, Enami T, Tatara R, Ikeda T (2017 Apr) Nutritional risk in allogeneic stem cell transplantation: rationale for a tailored nutritional pathway. Ann Hematol 96(4):617–625

    Article  Google Scholar 

  35. Hadjibabaie M, Iravani M, Taghizadeh M, Ataie-Jafari A, Shamshiri AR, Mousavi SA, Alimoghaddam K, Hosseini S, Ghavamzadeh A (2008) Evaluation of nutritional status in patients undergoing hematopoietic SCT. Bone Marrow Transplant 42:469–473

    Article  CAS  Google Scholar 

  36. Eduardo FP, Bezinelli LM, Gobbi MF, Pereira AZ, Vogel C, Hamerschlak N, Corrêa L (2018 Feb-Mar) Impact of oral and gastrointestinal mucositis on body weight alterations during hematopoietic stem cell transplantation. Nutr Cancer 70(2):241–248

    Article  Google Scholar 

  37. de Vries YC, Boesveldt S, Kelfkens CS, Posthuma EE, van den Berg MMGA, de Kruif JTCM, Haringhuizen A, Sommeijer DW, Buist N, Grosfeld S, de Graaf C, van Laarhoven HWM, Kampman E, Winkels RM (2018) Taste and smell perception and quality of life during and after systemic therapy for breast cancer. Breast Cancer Res Treat 170:27–34. https://doi.org/10.1007/s10549-018-4720-3

    Article  PubMed  PubMed Central  Google Scholar 

  38. Yamashita H, Nakagawa K, Hosoi Y, Kurokawa A, Fukuda Y, Matsumoto I, Misaka T, Abe K (2009 Mar) Umami taste dysfunction in patients receiving radiotherapy for head and neck cancer. Oral Oncol 45(3):e19–e23

    Article  Google Scholar 

  39. Sato T, Konuma T, Miwa Y, Sugihara N, Tsuru Y, Narita H, Kiriyama S, Kato S, Oiwa-Monna M, Kobayashi K, Takahashi S, Tojo A (2017 Nov) A cross-sectional study on late taste disorders in survivors of allogeneic hematopoietic cell transplantation. Ann Hematol 96(11):1841–1847

    Article  Google Scholar 

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Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil—finance code 001.

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Authors and Affiliations

  1. Bone Marrow Transplantation Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil

    Mariana Henriques Ferreira, Leticia Mello Bezinelli, Fernanda de Paula Eduardo, Roberta Marques Lopes, Andrea Z. Pereira & Nelson Hamerschlack

  2. General Pathology Department, School of Dentistry, University of São Paulo, 2227 Cidade Universitária, São Paulo, 05508-000, Brazil

    Mariana Henriques Ferreira & Luciana Corrêa

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  1. Mariana Henriques Ferreira
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  2. Leticia Mello Bezinelli
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  3. Fernanda de Paula Eduardo
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  4. Roberta Marques Lopes
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  5. Andrea Z. Pereira
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  6. Nelson Hamerschlack
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  7. Luciana Corrêa
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Correspondence to Luciana Corrêa.

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All procedures involving human participants were in accordance with the ethical standards of our institutional research committee (CAAE 55053516.7.0000.0071) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Ferreira, M.H., Mello Bezinelli, L., de Paula Eduardo, F. et al. Association of oral toxicity and taste changes during hematopoietic stem cell transplantation: a preliminary study. Support Care Cancer 28, 1277–1287 (2020). https://doi.org/10.1007/s00520-019-04922-x

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