Bone marrow stromal damage after chemo/radiotherapy: occurrence, consequences and possibilities of treatment.
High dose chemotherapy (CT) followed by bone marrow transplant (BMT) is increasingly used for the treatment of both hematological and solid neoplasms, but an understanding of its late consequences on the marrow microenvironment is still only at its beginning. It is in fact known that marrow stroma is damaged by high-dose cytotoxic therapy and by radiation exposure. However little is known on the extent of this damage and on the self-repair ability of the stroma. The damage of the stromal microenvironment affects the long-term stem cell engraftment and the maintenance of hemopoietic functions. Furthermore, marrow stroma also represents a progenitor compartment for endosteal osteoblasts, and therefore its damage implies alterations of bone metabolism. Indeed, osteoporosis has recently been recognized as a consequence, of BMT, but only a few studies have been performed to establish the functional status of the stromal compartment after treatment with cytotoxic drugs with or without total body irradiation (TBI) and its role in post-BMT sequelae.
Banfi
A
A
Istituto Nazionale per la Ricerca sul Cancro/Centro di Biotecnologie Avanzate, Genova, Italy.
Bianchi
G
G
Galotto
M
M
Cancedda
R
R
Quarto
R
R
D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects; D001853:Bone Marrow / Q000473:pathology*; D016723:Bone Remodeling / Q000187:drug effects / Q000528:radiation effects; D006410:Hematopoiesis / Q000187:drug effects / Q000528:radiation effects; D006412:Hematopoietic Stem Cells / Q000166:cytology; D006801:Humans; D017154:Stromal Cells / Q000187:drug effects* / Q000473:pathology / Q000528:radiation effects*; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014916:Whole-Body Irradiation / Q000009:adverse effects
D000970:Antineoplastic Agents