Stromal damage as consequence of high-dose chemo/radiotherapy in bone marrow transplant recipients

Exp Hematol. 1999 Sep;27(9):1460-6. doi: 10.1016/s0301-472x(99)00076-4.

Abstract

Bone marrow transplant (BMT) relies on the engraftment of donor hemopoietic precursors in the host marrow space. Colony forming units-fibroblasts (CFU-f), the precursor compartment for the osteogenic lineage, are essential to hemopoietic stem cell survival, proliferation and differentiation. We have studied CFU-f in donors (aged 5 months to 62 years) and in patients who had received allogeneic BMT (aged 2 months to 63 years). In donor marrows we found an inverse correlation between CFU-f frequency and age. In BMT recipients CFU-f frequencies were reduced by 60%-90% (p < 0.05) and the numbers did not recover up to 12 years after transplant. Stromal reconstitution to normal levels was found only in patients < 5 years old. In all patients studied CFU-f post-BMT were of host origin. Patients with low CFU-f levels displayed also a decreased bone mineral density (p < 0.05) and significantly reduced levels of long-term culture-initiating cells (LTC-IC) (p < 0.05). Our study demonstrates that the marrow stromal microenvironment is seriously and irreversibly damaged after BMT. Donor cells do not contribute to reconstitute the marrow microenvironment, whose residual CFU-fs remain of host origin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Bone Density / radiation effects
  • Bone Marrow Cells / drug effects
  • Bone Marrow Cells / pathology*
  • Bone Marrow Cells / radiation effects
  • Bone Marrow Transplantation / pathology*
  • Bone Remodeling / radiation effects
  • Child
  • Child, Preschool
  • Colony-Forming Units Assay
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / adverse effects*
  • Female
  • Follow-Up Studies
  • Genetic Diseases, Inborn / therapy
  • Hematologic Neoplasms / therapy
  • Hematopoiesis*
  • Humans
  • In Situ Hybridization, Fluorescence
  • Infant
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Radiation Injuries / pathology*
  • Stromal Cells / drug effects
  • Stromal Cells / pathology*
  • Stromal Cells / radiation effects
  • Thiotepa / administration & dosage
  • Thiotepa / adverse effects*
  • Tissue Donors
  • Transplantation Conditioning / adverse effects*
  • Transplantation, Homologous
  • Treatment Outcome
  • Whole-Body Irradiation / adverse effects*

Substances

  • Cyclophosphamide
  • Thiotepa