Salivary amylase and pancreatic enzymes in serum after total body irradiation.

Amylase increases in serum after total body irradiation (TBI). To investigate whether this increase is ascribable to pancreatic or salivary amylase, or both, we measured the post-irradiation activity concentration of the three major pancreatic enzymes (trypsin, amylase, and lipase) and of salivary-type amylase in serum from six leukemic patients given TBI before bone-marrow transplantation. Salivary amylase increased by as much as 50-fold after TBI, peaking on the first day after the irradiation. The increase was associated with the development of clinical parotitis. Pancreatic trypsin, total amylase, and lipase increased inconsistently and to a much smaller degree. There were no associated clinical features of pancreatitis. Our data show that, at the dose of radiation given to our patients, there is no danger of pancreatitis as a complication, but parotitis is a consistent development after TBI.