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Taste changes during hematopoietic steam cells transplantation (HSC) are often acknowledged after the transplantation, however little is known about which flavors and what types of perception changes are experienced by patients during this treatment. The aim of this study was to characterize taste and taste buds atrophy alterations present during the HSC, as well as to verify if there is association among these alterations and clinical variables related to the transplant and oral mucosal toxicity. The impact of taste and oral mucosa alterations on patients' quality of life was also evaluated. We selected 54 patients holding autologous and allogenic HSC, who underwent taste acuity tests prior to conditioning (T0), during neutropenia (T1) and engraftment (T2). It was carried out an acuity test in the perception of sweet, bitter, sour and salty flavors, offered in solutions containing low and high concentrations of watery substances stimulating these flavors. Patients were also submitted to oroscopy for evaluation of oral mucositis and taste buds atrophy. It was found that 69% of patients suffered taste alteration in T1 and 70% in T2. Also flavor intensity was wrongly reported more times by patients in T1 (79%) and T2 (78%) than prior to conditioning. Taste buds atrophy was observed in 74% of patients at T1 and 78% at T2, being correlated to change in the flavor (p = 0.037) at T2. Taste buds atrophy was inversely correlated to TBI treatment in their conditioning, with 42% of patients affected (p = 0.036). Finally, patients suffering mucositis for 7 days or longer presented more taste buds atrophy (p = 0.048).Conclusion: The oral mucositis duration, the conditioning regime and taste buds atrophy are factors that may be associated with greater taste alteration in patients submitted to HSC. [ABSTRACT FROM AUTHOR]

Regular analysis of demographic, clinical and outcome data is indispensable for ensuring and maintaining quality in a hematopoietic stem cell transplant (HSCT) center. For this, data needs to be extracted accurately. Organization accreditations such as FACT (Foundation for the Accreditation of Cellular Therapy) require submission of data to the US (CIBMTR) or the European (EBMT) Registries correctly. Due to discrepancies found between medical charts data and the data submitted to CIBMTR in the first FACT accreditation cycle (2012), our HSCT center decided to hire a dedicated data manager. We describe here the training and performance of the data manager in the process of collecting and transferring HSCT data to national and international registries. The professional hired as data manager received internal and external training. Externally, she attended national and international congresses and visited the CIBMTR (2016). Internally, she first received training by the clinical team about the forms to be filled in. Together with the HSCT multi-professional team, they evaluated the data collection process and defined which data should appear in the medical records. Appropriate outcomes were defined for data analysis based on literature searches, the FACT requirements and the need of the clinical staff, and the data manager was trained in data analysis using R. The clinical team together with data manager developed templates appropriate for the clinical follow-up of patients, such as the Dentistry to collect data on mucositis. The quality nurse developed a regular internal auditing system. One of the results was the reduction of three hours in filling out the forms (TED 2400). From the structuring, organization and updating of the database, it was possible to obtain relevant indicators on survival and cumulative incidence of acute and chronic graft versus host disease, transplant-related mortality and disease relapse. These are used by the HSCT team in clinical rounds and in critical analyses of the program performance. In re-accreditations (2015 and 2018) after hiring and training, no non-compliance was identified in item B9, related to the insertion and submission of transplant data. In 2017, the clinical team designed, with the data manager, an ethically-approved multicenter study until 2027, about on transplant-related outcomes, currently with 19 centers in Brazil that sending data to CIBMTR. Training of the data manager at our HSCT center (a profession not official in Brazil) allowed the development of strategies and tools that resulted in greater accuracy in data collection and analysis, and FACT-compliant. [ABSTRACT FROM AUTHOR]

During conditioning of hematopoietic stem cell transplantation, numerous chemotherapeutics are used, among them, busulfan (BU). This is an alkylating agent that generates intense toxicity induced by oxidative stress, which can lead to DNA damage and cause oral mucositis (MO). BU is found at salivary levels close to plasma levels, but it is not known whether salivary concentrations are toxic as much as plasma to the oral cavity. This work aimed to analyze oxidative stress and possible DNA damage in keratinocytes exposed to BU found in salivary doses. Human keratinocytes were cultured and the following groups were established: Control (no treatment), Control Saliva (exposure to artificial saliva) and BU (exposure to BU carried in saliva at 4.0, 4.5, 5.0 and 5.5 μg / mL). The cell viability and the number of cells with DNA fragmentation were evaluated by TUNEL assay, as well as the level of oxidative stress by quantification of sequestration of the radical DPPH, superoxide dismutase (SOD), catalase (CAT) and level of lipid peroxidation (PL). Through the comet assay, the percentage of fragmented DNA was evaluated. The effect of BU on keratinocytes was dose-dependent; the dose of 5.5 μg / mL without vehicle with saliva generated 76% cellular viability, differing from the Control group (p < 0.05); when the BU was delivered in saliva, all doses generated less viability than the BU without saliva (p < 0.001). In the TUNEL analysis, salivary BU treatment caused a higher frequency of cells with DNA fragmentation (p < 0.05 compared to controls), as well as lower sequestration potential of the DPPH radical (p < 0.05 compared to the controls). Catalase activity was higher in the BU group (p < 0.01 compared to the controls). Exposure to BU also generated a higher percentage of fragmented DNA (p < 0.05 compared to Control). It was concluded that the salivary concentration of BU is toxic to keratinocytes, inducing oxidative stress and increased DNA damage. [ABSTRACT FROM AUTHOR]