Ca. Lawton et al., EFFECT OF NEPHROTOXIC DRUGS ON THE DEVELOPMENT OF RADIATION NEPHROPATHY AFTER BONE-MARROW TRANSPLANTATION, International journal of radiation oncology, biology, physics, 28(4), 1994, pp. 883-889
Citations number
34
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: Chronic renal failure is a significant cause of late morbidit
y in bone marrow transplant patients whose conditioning regimen includ
es total body irradiation (TBI). Radiation is a major cause of this sy
ndrome (bone marrow transplant nephropathy), but it may not be the onl
y cause. These studies use a rat syngeneic bone marrow transplant mode
l to determine whether nephrotoxic agents used in conjunction with bon
e marrow transplantation (BMT) could be enhancing or accelerating the
development of radiation nephropathy. Methods and Materials: Rats rece
ived 11-17 Gy TBI in six fractions over 3 days followed by syngeneic b
one marrow transplant. In conjunction with the bone marrow transplants
, animals received either no drugs, cyclosporine, amphotericin, gentam
icin, or busulfan. Drugs were given in schedules analogous to their us
e in clinical bone marrow transplantation. Drug doses were chosen so t
hat the drug regimen alone caused detectable acute nephrotoxicity. Ani
mals were followed for 6 months with periodic renal function tests. Re
sults: Gentamicin had no apparent interactions with TBI. Amphotericin
increased the incidence of engraftment failure, but did not enhance ra
diation nephropathy. Cyclosporin with TBI caused late morbidity that a
ppeared to be due to neurological problems, but did not enhance radiat
ion nephropathy. Busulfan resulted in a significant enhancement of rad
iation nephropathy. Conclusion: Of the nephrotoxins used in conjunctio
n with bone marrow transplantation only radiation and busulfan were fo
und to be risk factors for bone marrow transplant nephropathy.