Jong, B. de (Bonne) (2013) Smaakdrempel bepaling bij acute myeloïde leukemie patiënten in de eerste fase van de behandeling: een exploratieve studie. thesis, Medicine.
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Abstract
Background: Most patients with acute myeloid leukemia (AML) undergo high-dose chemotherapy treatment followed by a hematopoetic cell transplant (HCT). Both can cause taste alterations. The latter of these treatments may cause persistent taste alterations. Taste disorders are frequently observed in oncological patients undergoing chemotherapy treatment and often have negative impact on quality of life. Furthermore taste alterations may have an association with: reduced appetite, malnutrition and diminished food appreciation. How much altered taste perception and taste sensitivity contributes in this issue, isn’t clear yet. A systematic review from 2012 (1) suggests that it may not be due to altered taste sensitivity, but rather hedonic components of food and other elements of flavor, which exert the greatest influence on how food and drinks are perceived during or after chemotherapy treatment. Previous studies which investigated taste sensitivity after chemotherapy treatment do not show a clear pattern on the outcome of the recognition (RT) -and detection treshold (DT). This pilot study will investigate taste sensitivity of AML patients in the first part of their treatment and compare the findings with healthy subjects in order to make a first step in research on taste alterations in acute hematologic malignancies. Methods: A total of 28 subjects where included in the study; 13 AML patients and 15 controls. Taste sensitivity (RT, DT) was determined for both groups by an adapted ‘modified Harris-Kalmus’ method. In this case by a series of 10 taste solutions. Patients where tested until the 22nd day of the chemotherapy regime (first and second cycle). Secondary endpoint of this study includes: taste loss, taste distortion and bad taste in the mouth (subjective chemosensory complaints). Mann-Withney U test was utilized to asses significance among the primary endpoints. Secondary endpoint where assessed by Chi-square –and Fisher’s exact test. Results: Outcome of the taste qualities sour and umami where not valid and are omitted from the interpretation. The studied groups differed in the independent variables mouthwashes (p = 0.01) and the use of antibiotics (P = 0.00). The sweet DT (p = 0.03) was significantly different between cases and controls. AML patients required increased concentrations of taste flavors in order to recognize sweet flavor. The expected negative effect of mouthwashes on taste sensitivity was not found in this study. Cases reported more subjective chemosensory complaints than controls did. Conclusion: There seems to be little affection on taste sensitivity in AML patients in the first part of their treatment. We only found higher sweet detection tresholds in AML patients under chemotherapy. The presence of subjective chemosensory complaints shows us that altered taste perception is a factor among these patients. Therefore research on altered taste should not be focused taste sensitivity, but rather on other elements of flavor, for instance smell and hedonics.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Kuiper-Kramer, Dr. P.A. and Isala Klinieken and locatie Sophia te Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:51 |
| Last Modified: | 25 Jun 2020 10:51 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1176 |
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