HEMATOPOIESIS OF TRANSPLANTED PATIENTS WITH AUTOLOGOUS MARROWS ASSESSED BY LONG-TERM MARROW CULTURE

We assessed the effect of antitumoural therapy at intensive doses on t he haemopoietic system using long-term marrow cultures (LTMC) establis hed from 33 patients (25 with haematological diseases and eight with s olid tumours) after autologous bone marrow transplantation (ABMT). Whe n compared to 42 pre-graft patients, a decreased CFU-GM production and a defect in stromal layer (SL) confluence were found after ABMT on da y 90 but also on day 365. However, these abnormalities were observed o nly in patients with haematological diseases and no differences betwee n pre-graft and post-graft results were found in patients with solid t umours. Among the patients with haematological diseases, on day 90 tho se with acute lymphoid leukaemias showed lower CFU-GM production where as patients with non-Hodgkin's lymphomas developed more frequently sub confluent or confluent SL. Other factors studied such as sex, patient age, disease status, marrow purging and post-graft administration of g rowth factors did not appear to influence post-graft LTMC results. Mul tivariate analysis including all the patients has shown (a) that solid tumours were associated with higher CFU-GM production, and (b) that c onditioning regimens with total body irradiation (TBI) or busulfan led more frequently to non-confluent SL. In conclusion, high-dose therapy followed by ABMT can induce a persistent impairment of the stem cell and stromal cell compartments, particularly in patients with haematolo gical diseases conditioned with TBI, despite the absence of any alloim mune reaction and post-graft immunosuppressive therapy.