# Comprehensive evaluation of taste dysfunction in allogeneic hematopoietic cell transplant recipients: a combined subjective and objective assessment

## TL;DR

This study evaluates taste changes in patients receiving blood cell transplants using both tests and self-reports, finding that taste issues are common and complex.

## Contribution

The study combines objective and subjective methods to assess taste dysfunction in allo-HCT recipients, revealing discrepancies in perception.

## Key findings

- Most patients showed taste dysfunction before transplantation, especially for sweet, salty, sour, and bitter.
- Subjective taste scores worsened post-transplant, while objective thresholds remained stable.
- GI-GVHD showed a trend for better umami taste preservation, and oral mucositis linked to taste distortions.

## Abstract

Taste dysfunction is a common but underrecognized complication in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). Taste dysfunction can adversely affect oral intake, nutritional status, and overall quality of life. This study aimed to comprehensively evaluate taste function in allo-HCT recipients using both objective and subjective measures and to identify clinical factors associated with taste disturbances.

We conducted a prospective observational study of 21 adult allo-HCT recipients. Taste function was assessed at two time points (pre-conditioning and pre-discharge) using the whole-mouth taste testing method for the five basic tastes and the Chemotherapy-induced Taste Alteration Scale (CiTAS). All 21 patients completed the CiTAS, and 19 patients underwent whole-mouth taste testing.

Most patients exhibited objective taste dysfunction before transplantation, particularly for sweet, salty, sour, and bitter taste qualities. The objective taste thresholds remained stable post-transplantation, but the subjective CiTAS scores worsened for basic taste, general alterations, and discomfort. There was a trend (p = 0.057) for objective umami taste to be better preserved in patients with gastrointestinal graft-versus-host disease (GI-GVHD). Oral mucositis was associated with higher phantogeusia/parageusia scores, while high malnutrition risk or weight loss correlated with lower subjective symptom scores.

The discrepancy between subjective and objective assessments of taste dysfunction highlights that taste perception is regulated by multifactorial and complex mechanisms. Intensive supportive care, which is often provided to severely ill patients, may offer psychological reassurance that indirectly improves self-reported taste symptoms. Whether umami sensitivity is influenced by systemic factors such as GI-GVHD requires further study.

The online version contains supplementary material available at 10.1007/s00520-026-10403-9.