Glenn J Lesser1, Megan B Irby2, Richard C Taylor3, Anna Snavely3, Douglas Case4, Aili Wang5, Andrea Dietrich6, Susan Duncan7. 1. Department of Internal Medicine, Section On Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA. glesser@wakehealth.edu. 2. Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA. 3. Department of Oncology, Mayo Clinic, Jacksonville, FL, USA. 4. Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA. 5. Key Laboratory of Coarse Cereal Processing, School of Food and Biological Engineering, Chengdu University, Chengdu, China. 6. Department of Civil and Environmental Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA. 7. Department of Food Science and Technology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
Abstract
PURPOSE: Taste and smell abnormalities (TSA) are common in patients receiving chemotherapy and may lead to altered nutritional intake, treatment withdrawal, and impaired quality of life. Lipid peroxidation in the oral cavity is one cause of TSA. Lactoferrin (LFN), an iron-binding salivary protein, reduces production of lipid oxidation byproducts and has been shown to reduce perception of unpleasant flavors. To assess the feasibility of LFN as a treatment for TSA, we conducted pilot investigations among patients with cancer who self-reported TSA following onset of chemotherapy. The primary objective was to assess change in subjective taste and smell perception from baseline to completion of 30 days of LFN supplementation. METHODS: Patients were treated with 750 mg LFN daily for 30 days and followed for an additional 30 days without LFN. TSA was measured via the taste and smell questionnaire (TSQ) including taste (score 0-10), smell (score 0-6), and composite scores (0-16) (0 = no TSA) at baseline, day 30, and day 60. RESULTS: A total of 26 patients enrolled; 19 remained on study at day 30 and 17 at day 60. Baseline mean TSQ scores were 6.5 (taste), 3.1 (smell), and 9.6 (composite). By day 30, mean composite TSQ score improved by 1.7 (p = 0.018); taste and smell improved by 0.6 (p = 0.062) and 1.1 (p = 0.042), respectively. From baseline to day 60, mean composite TSQ score improved by 3.8 (p < 0.0001); taste and smell improved by 1.9 (p = 0.001) and 1.8 (p = 0.003). CONCLUSIONS: Further evaluation of LFN is warranted to determine its value for improving self-reported TSA among patients receiving chemotherapy.
PURPOSE: Taste and smell abnormalities (TSA) are common in patients receiving chemotherapy and may lead to altered nutritional intake, treatment withdrawal, and impaired quality of life. Lipid peroxidation in the oral cavity is one cause of TSA. Lactoferrin (LFN), an iron-binding salivary protein, reduces production of lipid oxidation byproducts and has been shown to reduce perception of unpleasant flavors. To assess the feasibility of LFN as a treatment for TSA, we conducted pilot investigations among patients with cancer who self-reported TSA following onset of chemotherapy. The primary objective was to assess change in subjective taste and smell perception from baseline to completion of 30 days of LFN supplementation. METHODS: Patients were treated with 750 mg LFN daily for 30 days and followed for an additional 30 days without LFN. TSA was measured via the taste and smell questionnaire (TSQ) including taste (score 0-10), smell (score 0-6), and composite scores (0-16) (0 = no TSA) at baseline, day 30, and day 60. RESULTS: A total of 26 patients enrolled; 19 remained on study at day 30 and 17 at day 60. Baseline mean TSQ scores were 6.5 (taste), 3.1 (smell), and 9.6 (composite). By day 30, mean composite TSQ score improved by 1.7 (p = 0.018); taste and smell improved by 0.6 (p = 0.062) and 1.1 (p = 0.042), respectively. From baseline to day 60, mean composite TSQ score improved by 3.8 (p < 0.0001); taste and smell improved by 1.9 (p = 0.001) and 1.8 (p = 0.003). CONCLUSIONS: Further evaluation of LFN is warranted to determine its value for improving self-reported TSA among patients receiving chemotherapy.
Authors: C Ripamonti; E Zecca; C Brunelli; F Fulfaro; S Villa; A Balzarini; E Bombardieri; F De Conno Journal: Cancer Date: 1998-05-15 Impact factor: 6.860
Authors: R S Wickham; M Rehwaldt; C Kefer; S Shott; K Abbas; E Glynn-Tucker; C Potter; C Blendowski Journal: Oncol Nurs Forum Date: 1999-05 Impact factor: 2.172
Authors: S Blauwhoff-Buskermolen; C Ruijgrok; R W Ostelo; H C W de Vet; H M W Verheul; M A E de van der Schueren; J A E Langius Journal: Support Care Cancer Date: 2015-07-10 Impact factor: 3.603
Authors: Susan Mirlohi; Susan E Duncan; Michele Harmon; Doug Case; Glenn Lesser; Andrea M Dietrich Journal: Clin Oral Investig Date: 2014-03-05 Impact factor: 3.573