title: Genetic protection of repopulating hematopoietic cells with an improved MDR1-retrovirus allows administration of intensified chemotherapy following stem cell transplantation in mice.
abstract: This study was undertaken to analyze the hematotoxicity of paclitaxel (Taxol) and to test whether transduction of repopulating hematopoietic cells with a retroviral vector (SF1m) expressing the human multidrug resistance 1 gene (MDR1) would permit dose intensification following bone marrow transplantation (BMT). While the regimen chosen (8 x 20 mg/kg i.p. within 12 days) produced a non-lethal, reversible hematotoxicity in mice with steady-state hematopoiesis, only 35.3% (6/17) of control mice survived when treated starting 14 days post BMT. In contrast, 83.3% (15/18) of mice transplanted with SF1m-transduced cells survived, owing to a significant protection against severe acute myelotoxicity (as determined by neutrophil counts, white and red blood cell counts and values for hemoglobin and hematocrit). After recovery from chemotherapy, an increase of myeloid cells that were resistant to colchicine and effluxed the fluorochrome Rhodamine 123 was observed in SF1m-mice, but not in controls. These results reveal that the lethal, dose-limiting hematotoxicity of an intensified post-transplantation chemotherapy with paclitaxel can be prevented by retroviral transfer of the MDR1 gene to a minor proportion of repopulating cells. Our mouse model, mimicking clinically achievable gene transfer rates, thus suggests that bone marrow chemoprotection may widen the therapeutic window and permit an earlier onset of post-transplantation chemotherapy.
authors.affiliation: Department of Cell and Virus Genetics, Heinrich-Pette-Institute, Hamburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Carpinteiro
authors.forename: Stefan
authors.initials: S
authors.lastname: Peinert
authors.forename: Wolfram
authors.initials: W
authors.lastname: Ostertag
authors.forename: Axel R
authors.initials: AR
authors.lastname: Zander
authors.forename: Dieter K
authors.initials: DK
authors.lastname: Hossfeld
authors.forename: Klaus
authors.initials: K
authors.lastname: Kühlcke
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Eckert
authors.forename: Christopher
authors.initials: C
authors.lastname: Baum
authors.forename: Susanna
authors.initials: S
authors.lastname: Hegewisch-Becker
mesh_terms: D000818:Animals; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D001772:Blood Cell Count; D003114:Colony-Forming Units Assay; D018014:Gene Transfer Techniques; D019450:Genes, MDR / Q000502:physiology*; D015316:Genetic Therapy / Q000379:methods; D005822:Genetic Vectors; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D051379:Mice; D008810:Mice, Inbred C57BL; D017239:Paclitaxel / Q000008:administration & dosage*; D012190:Retroviridae / Q000235:genetics
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel