Abstract
Salivary gland involvement in chronic GVHD (cGVHD) is indicated by increased dryness of the oral cavity, abnormalities in the saliva and histopathological changes in labial minor salivary glands. Salivary changes leading to 45–60% of hyposalivation have been reported in cGVHD in both and human studies. Fibrosis and inflammatory infiltration were the mostly important histopathological changes observed in oral cGVHD minor salivary glands biopsies. The aim of this study was to evaluate prospectively the side effects of the conditioning regimen used for allogeneic BMT on major salivary gland using scintigraphy with Gallium-67 and technetium-99m-pertechnetate. This is an ongoing study performed in the University Hospital of State University of Campinas-Brazil. Between March 2002 until July 2003, fifteen Chronic Myeloid Leukemia (CML) and three Severe Aplastic Anemia (SAA) patients submitted to conventional allogeneic BMT were enrolled. Ten of them are female and 8 are male and the median age of this group was 39 yo (31–55 years). Conditioning regimen and GVHD prophylaxis used following Institutional protocols. Scintigraphic exams was performed at Division of Nuclear Medicine, using 10mCi of Technetium-99m pertechnetate and 3mCi of Gallium-67, intravenously. Gallium-67 images were done after 48 hours of intravenous injection. Gallium-67 and Technetium data are summarized in Table 1 and Table 2, respectively. These data are preliminary. Scintigraphy showed an increase of inflammatory reaction and a functional deficit in major salivary glands after BMT. Salivary glands dysfunction maybe due to cGVHD or side-effect related to high dose chemotherapy. It is not clear in the literature the differentiation between salivary gland dysfunction due to cGVHD and long-term related high dose chemotherapy. TablePreliminary Results of Gallium-67 Scintigraphic Study on Major Salivary Glands (n = 18 patients)Submandible (n patients)Parotid (n patients)PositiveNegativePositiveNegativeBefore BMT117018Day +30 after59311Day + 60 after76310Day + 100 after7649
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