title: Frequent induction of chromosomal aberrations in in vivo skin fibroblasts after allogeneic stem cell transplantation: hints to chromosomal instability after irradiation.
abstract: BACKGROUND
  Total body irradiation (TBI) has been part of standard conditioning regimens before allogeneic stem cell transplantation for many years. Its effect on normal tissue in these patients has not been studied extensively.
  
  
  METHODS
  We studied the in vivo cytogenetic effects of TBI and high-dose chemotherapy on skin fibroblasts from 35 allogeneic stem cell transplantation (SCT) patients. Biopsies were obtained prospectively (n = 18 patients) before, 3 and 12 months after allogeneic SCT and retrospectively (n = 17 patients) 23-65 months after SCT for G-banded chromosome analysis.
  
  
  RESULTS
  Chromosomal aberrations were detected in 2/18 patients (11 %) before allogeneic SCT, in 12/13 patients (92 %) after 3 months, in all patients after 12 months and in all patients in the retrospective group after allogeneic SCT. The percentage of aberrant cells was significantly higher at all times after allogeneic SCT compared to baseline analysis. Reciprocal translocations were the most common aberrations, but all other types of stable, structural chromosomal aberrations were also observed. Clonal aberrations were observed, but only in three cases they were detected in independently cultured flasks. A tendency to non-random clustering throughout the genome was observed. The percentage of aberrant cells was not different between patients with and without secondary malignancies in this study group.
  
  
  CONCLUSIONS
  High-dose chemotherapy and TBI leads to severe chromosomal damage in skin fibroblasts of patients after SCT. Our long-term data suggest that this damage increases with time, possibly due to in vivo radiation-induced chromosomal instability.
authors.affiliation: Department of Hematology, Oncology and Tumor Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany. gero.massenkeil@klinikum-guetersloh.de.|Present address: Department of Internal Medicine, Clinic for Hematology and Oncology, Klinikum Guetersloh, Guetersloh, Germany. gero.massenkeil@klinikum-guetersloh.de.
authors.forename: G
authors.initials: G
authors.lastname: Massenkeil
authors.affiliation: Institute for Medical Genetics, Charité Universitätsmedizin Berlin, Berlin, Germany.|Present address: Medical practice for Human Genetics, Friedrichstrasse, Berlin, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Zschieschang
authors.affiliation: Institute for Medical Genetics, Charité Universitätsmedizin Berlin, Berlin, Germany.|Present address: Medical practice for Human Genetics, Friedrichstrasse, Berlin, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Thiel
authors.affiliation: Department of Hematology, Oncology and Tumor Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: P G
authors.initials: PG
authors.lastname: Hemmati
authors.affiliation: Clinic for Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Budach
authors.affiliation: Department of Hematology, Oncology and Tumor Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Dörken
authors.affiliation: Department of Hematology, Oncology and Tumor Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Pross
authors.affiliation: Department of Hematology, Oncology and Tumor Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Arnold
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D002869:Chromosome Aberrations / Q000528:radiation effects*; D005260:Female; D005347:Fibroblasts / Q000528:radiation effects*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012867:Skin / Q000528:radiation effects; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D014916:Whole-Body Irradiation / Q000009:adverse effects*; D055815:Young Adult