Hematopoietic damage prior to PBSCT and its influence on hematopoietic recovery.
Hematopoietic damage prior to PBSCT and its influence on hematopoietic recovery.
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发表时间：
1999
期刊：
影响因子：
10.1
通讯作者：
M. D. del Cañizo;N. López;L. Vázquez;M. E. Fernandez;B. Ana;M. Caballero;M. Amigo;M. Mateos;N. Gutiérrez;J. F. San Migue
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作者：
M. D. del Cañizo;N. López;L. Vázquez;M. E. Fernandez;B. Ana;M. Caballero;M. Amigo;M. Mateos;N. Gutiérrez;J. F. San Migue
背景与目的恶性肿瘤患者接受化疗以诱导肿瘤缓解，但化疗可能会损害造血功能，对移植后的造血重建产生不利影响。在本研究中，我们使用长期培养（LTBMC）系统和克隆形成试验来评估选择接受外周血干细胞移植（PBSCT）的患者的骨髓损伤。设计与方法35例患者，其中乳腺癌（BC）20例，非霍奇金淋巴瘤（NHL）9例，霍奇金病（HD）6例。在开始预处理治疗前一天进行骨髓穿刺。用PHA-LCM在甲基纤维素中培养CFU-GM。根据Gordon方法进行可塑性贴壁祖细胞（PD）的Delta测定。建立LTBMC 5周。结果各患者骨髓CFU-GM均低于正常骨髓（p <0.05）。相反，未成熟祖细胞（PD）的数量没有减少。LTBMC患者的CFU-GM总数明显减少（p <0.05）。来自患者的粘附层通常在性质上不同。为了了解造血损伤是否会影响造血重建，我们将培养数据与达到外周血细胞计数所需的时间相关联。基质层百分比与达到20 × 10（9）血小板/L所需时间呈负相关（r =-0.71）（tplat = 20 × 3 - 0.08%基质层）。解释和结论：我们可以得出结论，PBSCT之前，造血功能受损的水平上的定向祖细胞和骨髓基质。这种损伤可能会影响血小板的恢复。
BACKGROUND AND 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). DESIGN AND 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). INTERPRETATION AND 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.