Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster Display session 1

5437 - Salivary cytokines and oral mucosa cells apoptosis in patients during hematopoietic cell transplantation: possible relationship with oral mucositis


28 Sep 2019


Poster Display session 1


Supportive Care and Symptom Management

Tumour Site


Luciana Corrêa


Annals of Oncology (2019) 30 (suppl_5): v718-v746. 10.1093/annonc/mdz265


L. Corrêa1, L.M. Bezinelli2, F.C.P. Rosin3, M.H. Ferreira2, D.L.C. Carvalho2, R.M.D.G. Lopes2, N. Hamerschlak2, F.D.P. Eduardo2

Author affiliations

  • 1 Pathology, Dentistry, Universidade de Sao Paulo, 05508-000 - Sao Paulo/BR
  • 2 Hematology/oncology, Hospital Israelita Albert Einstein, 05652-900 - São Paulo/BR
  • 3 Hematology/oncology, Hospital Israelita Albert Einstein, 05652900 - São Paulo/BR


Login to get immediate access to this content.

If you do not have an ESMO account, please create one for free.

Abstract 5437


Apoptosis has a central role in the process of oral mucositis and can be sustained by proinflammatory cytokines. Some studies have demonstrated increased levels of tumor necrosis factor alpha (TNF-α), interleukin 1β (IL-1β) and interleukin 6 (IL-6) in saliva after radiotherapy and chemotherapy, which has been associated to severe oral mucositis. However, little is known about the role of these cytokines in the pro and anti-apoptosis process of oral cells exposed to antineoplastic agents. The aim of this study was to verify whether there was an association of salivary cytokines with oral cells exhibiting apoptosis or anti-apoptotic Bcl-2 expression in patients who experienced oral mucositis during hematopoietic cell transplantation (HCT).


We collected saliva and oral mucosa cells from 77 HCT patients before the conditioning (T0), during the neutropenia period (T1), and after the marrow recovery (T2). We quantified the oral exfoliated cells exhibiting TUNEL positivity and immunocytochemical expression of Bcl-2. We also determined the salivary levels of TNF-α, IL-1β, and IL-6 in the three periods.


The number of cells exhibiting positivity to TUNEL (p = 0.021) and Bcl-2 (p = 0.020) increased from T0 to T2. The levels of TNF-α increased significantly from T0 to T1 (p < 0.001). There were no significant alterations of IL-1β and IL-6 comparing the three periods. There was a significant positive correlation between TNF-α and TUNEL in T0 (rho=0.277, p = 0.033) and T1 (rho=0.451, p = 0.020). Bcl-2 expression in T1 (rho=--0.335, p = 0.048) was negatively correlated with time duration of oral mucositis.


Oral cells exhibited apoptosis even after the marrow recovery. Oral cells apoptosis was associated with salivary TNF-α during the neutropenia period. Oral cells also exhibited high expression of antiapoptotic protein Bcl-2, which was inversely proportional to the duration of oral mucositis, suggesting the activation of a surveillance mechanism in the oral cells. Alterations on salivary TNF-α during the HCT may have a putative role in the apoptosis presented in oral mucositis.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Hospital Israelita Albert Einstein.


São Paulo Research Foundation (2016/03650-4) and AmigoOH - Brazil.


All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.