Hematopoietic stem cell compartment: acute and late effects of radiation therapy and chemotherapy.
The bone marrow is an important dose-limiting cell renewal tissue for chemotherapy, wide-field irradiation, and autologous bone marrow transplantation. Over the past 5-10 years a great deal has been discovered about the hematopoietic stem cell compartment. Although the toxicity associated with prolonged myelosuppression continues to limit the wider use of chemotherapy and irradiation, ways are being discovered to circumvent this toxicity such as with the increasing use of cytokines. This review describes what is known of how chemotherapy and irradiation damage stem cells and the microenvironment, how cytokines protect hematopoietic cells from radiation damage and speed marrow recovery after chemotherapy or marrow transplantation, and how various types of blood marrow cells contribute to engraftment and long-term hematopoiesis after high doses of cytotoxic agents and/or total body irradiation.
Mauch
P
P
Joint Center for Radiation Therapy, Department of Radiation Oncology, Harvard Medical School, Boston, MA 02115, USA.
Constine
L
L
Greenberger
J
J
Knospe
W
W
Sullivan
J
J
Liesveld
J L
JL
Deeg
H J
HJ
D000818:Animals; D001855:Bone Marrow Diseases / Q000209:etiology / Q000628:therapy; D016026:Bone Marrow Transplantation; D004285:Dogs; D016298:Hematopoietic Cell Growth Factors; D006412:Hematopoietic Stem Cells / Q000166:cytology / Q000187:drug effects* / Q000528:radiation effects*; D006801:Humans; D051379:Mice; D011829:Radiation Dosage; D011836:Radiation Tolerance; D011878:Radiotherapy / Q000009:adverse effects; D014916:Whole-Body Irradiation
D016298:Hematopoietic Cell Growth Factors