Published in Cancer Detection and Prevention 2000; 24(Supplement 1).

Major salivary glands involvement in patients with hematological malignancies following bone marrow transplantation

RM Nagler MD MSc PhD 1, A Nagler MSc MD 2

1 Dept Oral And Maxillofacial Surgery, Oral Biochemistry Laboratory and Salivary Clinic, Faculty Of Medicine, Technion-Israel Institute of Technology, and Rambam Medical Center, Haifa, Israel, 2 Dept Bone Marrow Transplantation and Cancer Biology Research Laboratory, Hadassah University Hospital, Jerusalem, Israel,

AIM: Chronic graft-versus-host disease (GVHD) is a complex clinical entity with various target organs including the salivary glands. The purpose of the current study was to evaluate the effect of oral pilocarpine (Salagen ,30mg/d) on the salivary biochemical and immunological composition in cGVHD patients treated by oral pilocarpine. METHODS: Baseline concentrations of salivary sodium (Na), magnesium (Mg), as well as total protein (TP), albumin (Alb), epidermal growth factor (EGF), immunoglobulins A and G (IgA and IgG) and electrolytes were evaluated. Results. All non-electrolytes demonstrated a trend for significant increase in the cGVHD patients in comparison with controls at both resting and stimulated conditions. In contrast, the salivary levels of potassium (P), calcium (Ca) and phosphate (P) were not altered in the cGVHD patients in comparison with controls. The resting salivary concentrations of TP, IgA and IgG were higher than in controls by 78% (p<0.05), 88% (NS) and 182% (p<0.05) while that the differences in concentrations of Alb and EGF were statistically non significant. At stimulated condition the salivary concentrations of TP, IgA, IgG, Alb and EGF were higher than in controls by 58%(p<0.05), 115%(p<0.05), 67%(p<0.05), 63%(NS), and 190%(p<0.05) respectively. The Salagen treatment reduced the resting salivary concentrations of TP, Alb, EGF, IgA and IgG by 40%(p<0.05), 70%(p<0.05), 52%(p<0.01), 59%(p<0.05), and 49%(p<0.05) respectively while that it reduced these salivary concentrations at stimulated condition by 34%(p<0.01), 60%(p<0.01), 64%(p<0.05), 43%(p<0.05) and 25%(NS) respectively. CONCLUSION: Our results demonstrate that oral pilocarpine normalized and reversed salivary biochemical and immunological alterations induced by cGVHD which is of vast importance in light of the heavily immunosupression and susceptibility to overwhelming infection episodes that these patients are prone for.

KEY WORDS: Hematological cancer, treatment, saliva, Bone marrow transplantation.

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Paper presented at the International Symposium on Impact of Biotechnology on Cancer Diagnostic & Prognostic Indicators; Geneva, Switzerland; October 28 - 31, 2000; in the section on chemotherapy.