Hematopoietic damage prior to PBSCT and its influence on hematopoietic recovery.
OBJECTIVE
Patients with malignancies receive chemotherapy to induce tumor remission which could damage hematopoiesis and adversely influence hematopoietic reconstitution after transplantation. In the present study we used a long-term culture (LTBMC) system and clonogenic assays to evaluate the marrow damage in patients selected to receive peripheral blood stem cell transplantation (PBSCT).


METHODS
Thirty-five patients - 20 with breast cancer (BC), 9 with non-Hodgkin's lymphoma (NHL) and 6 with Hodgkin's disease (HD) - were included. Bone marrow aspiration was performed one day prior to the initiation of the conditioning therapy. CFU-GM were cultured in methylcellulose with PHA-LCM. Delta assays of plastic adherent progenitor cells (PD) were performed according to Gordon's method. LTBMC were established for 5 weeks.


RESULTS
There were fewer CFU-GM from all patient groups than from normal BM (p<0.05). In contrast, the number of immature progenitor cells (PD) was not decreased. The total number of CFU-GM produced by LTBMC patients was significantly reduced (p<0.05). The adherent layer from patients was often qualitatively different. In order to know whether the hematopoietic damage could affect hematopoietic reconstitution, we correlated culture data with time taken to reach peripheral cell counts. A negative correlation (r= - 0.71) was found between percentage of stromal layer and time taken to reach 20x10(9) platelets/L (tplat= 20x3-0.08% stromal layer).


CONCLUSIONS
We can conclude that prior to PBSCT, hematopoietic function is impaired at both the level of committed progenitor cells and that of BM stroma. This damage could influence platelet recovery.
del Cañizo
M C
MC
Servicio de Hematología, Hospital Universitario, Paseo de San Vicente 58-182, 37002 Salamanca, Spain.
Lopez
N
N
Vazquez
L
L
Fernandez
M E
ME
Ana
B
B
Caballero
M D
MD
Amigo
M L
ML
Mateos
M V
MV
Gutierrez
N
N
San Migue
J F
JF
D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis; D001854:Bone Marrow Cells / Q000166:cytology; D001855:Bone Marrow Diseases / Q000188:drug therapy / Q000503:physiopathology*; D002478:Cells, Cultured / Q000276:immunology; D003114:Colony-Forming Units Assay; D005260:Female; D006410:Hematopoiesis / Q000187:drug effects / Q000502:physiology*; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D018952:Antigens, CD34