Saliva secretion and abnormal moistening of oral mucosa after bone marrow transplantation.

Haematopoietic Stem Cell Transplantation (HSCT) is one of the methods to treat neoplasmatic blood diseases. This treatment is cause of several complications, some of which affecting the oral cavity. Patients who had undergone the treatment frequently experienced oral dryness some time thereafter. The aim of the study was to compare the level of moistening of the oral mucosa with the rate of secretion of the stimulated and non-stimulated saliva at various times after the patient underwent the bone marrow transplant. The study involved 46 patients 18 women and 28 men, aged 19 to 54 (mean 38.3 +/- 10.5 years), between 100 days and 6 years following the HSCT (mean 18.7 +/- 15.7 months). In each of the patients the over all look and moistening of the oral mucosa, as well as the rate of secretion of stimulated and non-stimulated saliva were assessed. Most of the HSCT patients had abnormal moistening of oral mucosa. Those with normal moistening exhibited average rates of both stimulated and non-stimulated saliva secretion significantly higher than patients with abnormal moistening of oral mucosa.

Differences in kinetics of donor lymphoid cells in response to G-CSF administration may affect the incidence and severity of acute GvHD in respective HLA-identical sibling recipients.

Granulocyte-colony stimulating factor (G-CSF), in addition to myeloid and stem cells, mobilizes a large number of lymphoid cells. We examined which lymphoid populations were mobilized in 21 consecutive donors of peripheral blood stem cells (PBSC) and whether the differences in mobilization could affect the incidence of acute and chronic GvHD in respective HLA-identical recipients. G-CSF administration induced significant increases of donor B (CD3-CD19+) lymphocytes and slight increases of T (CD3+) and cytotoxic (CD16+CD56+) NK cells. The number of extrathymic cells (CD3+ cells with NK markers, or CD7+) remained unchanged except for an increase of CD3+CD57+CD8+ cells. Donors of patients without subsequent grade II-IV acute GvHD compared to donors of patients who developed significant acute GvHD were found to have in peripheral blood stable numbers of CD3+CD4+ cells producing IL2, with a concomitant increased number of CD3+CD4low+CD25+ T regulatory cells and decreased NK-mediated cytotoxicity, together with a higher number of suppressive extrathymic CD57+CD3+ cells in the blood and G-PBMC grafts. Increasing numbers of activated T and NK cells in the blood were associated with the development of chronic GvHD. We suggest that differences in steady-state levels and kinetics of G-CSF induced mobilization of donor lymphoid cells may in addition to other well-known factors affect the incidence of GvHD in HLA-identical recipients. However, owing to the small number of donor-recipient pairs studied, our results must be verified in a larger group of patients.