Unlocking the Complex Flavors of Dysgeusia after Hematopoietic Cell Transplantation

Abstract

Dysgeusia is a frequently occurring symptom after hematopoietic cell transplantation (HCT) that has important long-term effects on physical, nutritional, and immunologic recovery, as well as on quality of life. Despite the relevance of this symptom, the study of dysgeusia in patients undergoing HCT has been limited, owing in part to its complexity. In this article, we review normal taste function and its clinical evaluation, discuss how dysgeusia uniquely affects patients undergoing HCT, and examine distinct, transplantation-related contributors to dysgeusia that may help elucidate strategies to ultimately reduce this symptom burden after transplantation.

Keywords: Dysgeusia; Hematopoietic cell transplantation; Taste disturbances.

Figure 1.. Schematic of Basic Taste Pathway

This simple schematic (not every aspect of this complex pathway is shown) shows the basic taste pathway. Taste molecules stimulate taste receptors, located on taste buds in the oropharynx. These taste signals are carried by afferent nerve fibers of cranial nerves (CN) with branches converging at the nucleus tractus solitarius (NTS). The gustatory signal then projects to the parabrachial nucleus (PBN) in the pons. From there, connections are made in the thalamus, amygdala, and insular cortex of the brain where this complex system is integrated into a gustotopic map corresponding to specific taste qualities (Adapted from references , , and 18).