The effect of haematiopoietic cell transplantation (HCT) on hyposalivation, xerostomia and caries progression

Haematopoietic cell transplantation is an established treatment option for (malignant) blood diseases like leukaemia. This treatment, which is preceded by chemotherapy and/or radiation therapy, is known to cause oral side effects. The mean salivary flow rate decreased shortly after transplantation, was lowered 3 months thereafter, and recovered to baseline levels after 12 months. Many patients experienced mouth dryness: complaints increased shortly after treatment and, even though complaints decreased in the long term, 73% of the patients still experienced mouth dryness 5 years after the transplantation. A shortage of saliva produced under resting conditions (unstimulated saliva), was likely to cause mouth dryness complaints, but also patients with a normal salivary flow rate experienced complaints. If the salivary flow rate could not be stimulated sufficiently by chewing, the risk of cavities increased.