MAJOR SALIVARY-GLAND DYSFUNCTION IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES RECEIVING INTERLEUKIN-2-BASED IMMUNOTHERAPY POST-AUTOLOGOUS BLOOD STEM-CELL TRANSPLANTATION (ABSCT)

Interleukin-2 (IL-2) is known to cause xerostomia and skin manifestati ons similar to graft-versus-host disease (GVHD). We therefore evaluate d major salivary gland function in patients with hematological maligna ncies treated with IL-2 and interferon-alpha (IFN-alpha) after ABSCT. Eleven patients (seven male, four female) of median age 40 (24-47) mer e evaluated, seven with non-Hodgkin lymphoma (NHL); one with Hodgkin's disease (HD) and three with acute myelogenous leukemia (AML). Parotid and submandibular salivary gland function was assessed before, during and after IL-2/IFN-alpha administration by evaluation of the salivary flow rate and the composition of secreted saliva. Significant reducti ons in both the resting and stimulated parotid and submandibular saliv ary how rates were observed during IL-2/IFN-alpha immunotherapy compar ed with the pre- and post-therapy values (P < 0.01), while no hyposali vation was observed in the control patients who underwent ABSCT and di d not received IL-2. Sialochemical evaluation revealed a significant i ncrease in potassium concentration (24.4 +/- 0.6 mEq/l to 28.9 +/- 1.4 mEq/l) and a significant decrease in sodium concentration (6.7 +/- 2. 1 mEq/l to 3.3 +/- 1.0 mEq.l) (P < 0.05) in the stimulated parotid gla nd saliva secreted during IL-2/IFN-alpha administration. Salivary prot ein concentrations were not altered by the IL-2/IFN-alpha immunotherap y. Similar changes were previously observed in mice and humans with ch ronic GVHD. We conclude that IL-2 immunotherapy induces major salivary gland dysfunction in humans, similar to our previous observations in patients with chronic GVHD, which may indicate similar pathophysiologi c mechanisms.