The mechanisms involved in the impairment of hematopoiesis after autologous bone marrow transplantation.
Hematopoiesis after autologous bone marrow transplantation (BMT) is characterized by a prolonged and severe deficiency of marrow progenitors for several years, especially of erythroid and megakaryocyte progenitors, while the peripheral blood cells and marrow cellularity have reached relatively normal values within a few weeks. These anomalies are comparable to those reported for allogeneic BMT, despite the absence of any allo-immune reaction or post-graft immunosuppressive therapy. Post-graft hematopoietic impairment is the consequence of quantitative and qualitative changes involving both stem cell and stromal compartments which are expressed by an impaired capacity of stem cell self-renewal and commitment towards erythroid and megakaryocytic lineages. Besides the toxicity of conditioning regimens, hematopoietic reconstitution using autologous grafts is particularly dependent on a combination of factors related to the patient, such as underlying disease and pre-graft chemotherapy regimens, and to the graft processing itself, such as in vitro purging with chemotherapeutic agents.
Domenech
J
J
Laboratory of Hematology, Bretonneau University Hospital, Tours, France.
Roingeard
F
F
Binet
C
C
D000970:Antineoplastic Agents / Q000009:adverse effects; D001853:Bone Marrow / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D016465:Bone Marrow Purging / Q000009:adverse effects; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000276:immunology; D002465:Cell Movement; D003238:Connective Tissue / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000473:pathology; D006410:Hematopoiesis / Q000502:physiology*; D016298:Hematopoietic Cell Growth Factors / Q000502:physiology / Q000627:therapeutic use; D006412:Hematopoietic Stem Cells / Q000187:drug effects / Q000473:pathology; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000209:etiology* / Q000503:physiopathology; D007239:Infections / Q000209:etiology; D019172:Transplantation Conditioning / Q000009:adverse effects; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
D000970:Antineoplastic Agents; D016298:Hematopoietic Cell Growth Factors