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Salivary and serum concentrations of busulfan and their association with salivary alterations and mucositis in patients undergoing hematopoietic stem cell transplantation.

Abstract

Chemotherapeutic regimen with busulfan (Bu) has been extensively applied to the treatment of neoplastic and non-neoplastic hematological disturbances, leading to satisfactory results regarding to success of hematopoietic stem cells transplantation (HSCT). Individual monitoring of Bu dosage is required for determination of the ideal therapeutic levels and for minimizing the systemic toxicity. Various blood collections are necessary for this monitoring, which is costly and uncomfortable to the patients. The saliva has been studied as a possible alternative fluid for the establishment of the individual Bu dosage. The first objective of this project is to verify the viability on using of salivary Bu concentration analysis during individual dose adjustments before the chemotherapeutic conditioning of the HSTC. Other question addressed in this project is about the secondary effects of salivary Bu on oral mucosa, mainly regarding mucositis and xerostomia. The second objective of this study is to verify whether there is association between salivary alterations, cytological alterations on oral mucosa, grades of mucosite, and Bu concentrations in the saliva. Serum and salivary Bu concentrations will be measured, as well as salivary dosage of total proteins, albumin, amylase, antioxidants enzymes (superoxide dismutase, catalase, and glutathione reductase), and IL-1², IL-6, and TNF-± cytokines. Oral cytological analysis and detection of apoptosis in oral epithelial cells will be also performed. If the salivary Bu analysis are efficient for pharmacokinetics monitoring in HSCT, this method will facilitate the individual Bu dosage adjustment in chemotherapy and HSCT centers. In addition, one expects that the result derived from the present project allow the establishment of Bu toxicity indicators using saliva and oral cytology analyses. The adoption of early preventive actions to reduce the frequency and severity of Bu-related mucositis can contribute with the HSCT success and the improvement of patient´s quality of life. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
EDUARDO, FERNANDA P.; BEZINELLI, LETICIA MELLO; GOBBI, MARCELLA; ROSIN, FLAVIA C. P.; CARVALHO, DANIELLE L. C.; FERREIRA, MARIANA HENRIQUES; DA SILVA, CINTHYA CORREA; HAMERSCHLAK, NELSON; CORREA, LUCIANA. Retrospective study of the digestive tract mucositis derived from myeloablative and non-myeloablative/reduced-intensity conditionings with busulfan in hematopoietic cell transplantation patient. SUPPORTIVE CARE IN CANCER, v. 27, n. 3, p. 839-848, MAR 2019. Web of Science Citations: 0.

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