Minor salivary glands: late effects in chronic graft-versus-host disease

Aims: to study minor salivary glands (MSG) sequential biopsies during chronic graft-versus-host (cGVHD) therapy. Material and Methods: MSG samples from 23 allogeneic bone marrow transplantation (A-BMT) patients were analyzed: 14 with cGVHD and 9 without. The conditioning regimen and cGVHD prophylaxis followed institutional protocols. In cGVHD patients, a second biopsy was obtained at the end of the treatment. Sections were stained with HE and PAS, and also for leukocyte common antigen. Histopathological features were classified according to Hornxs criteria. Density of inflammatory cells was mesaured in digitalized images. PAS-positive-glycoproteins were quantified by an interactive software. Results: Patients with cGVHD showed significantly less PAS positive acinar mucus when compared with patients without. Patients with worsening of cGVHD during therapy lost mucous substances, whereas patients responding to treatment showed an increase. Density of inflammatory inflitrate was significantly less in patients without cGVHD and was inversely proportional to changes of the cGVHD score during treatment. Patient’s age was significantly associated with a worse response to treatment.(Spearmanxs correlation for change of GVHD score: rs= 0,71; p = 0,0047; for change of mucous substances: rs = -0,57; p =0,03). Conclusions: Our results emphasize the importance of age for the sucess of treatment and suggest that the persistent xerostomia after cGVHD treatment might be due to absence of the SG secretor unit recovery. (Supported by CNPq - 105937/2003-7)