Molyneux Gemma, Gibson Frances M, Gordon-Smith Edward C, Pilling Andrew M, Liu Kai Chiu, Rizzo Sian, Sulsh Susan, Turton John A
Department of Haematology, St George's Hospital Medical School, London, UK.
Int J Exp Pathol. 2005 Dec;86(6):415-30. doi: 10.1111/j.0959-9673.2005.00452.x.
Mitomycin (MMC), like many antineoplastic drugs, induces a predictable, dose-related, bone marrow depression in man and laboratory animals; this change is generally reversible. However, there is evidence that MMC may also cause a late-stage or residual bone marrow injury. The present study in female CD-1 mice investigated the haematological and bone marrow changes induced by MMC in a repeat dose study lasting 50 days. Control and MMC-treated mice were dosed intraperitoneally on eight occasions over 18 days with vehicle, or MMC at 2.5 mg/kg, autopsied (n = 6-12) at 1, 7, 14, 28, 42 and 50 days after the final dose and haematological changes investigated. Femoral nucleated bone marrow cell counts and levels of apoptosis were also evaluated and clonogenic assays carried out; serum levels of FLT3 ligand (FL) were assessed. At day 1 post-dosing, MMC induced significant reductions in RBC, Hb and haematocrit (HCT) values, and there were decreases in reticulocyte, platelet, and femoral nucleated cell counts (FNCC); neutrophil, lymphocyte and monocyte values were also significantly reduced. On days 7 and 14 post-dosing, all haematological parameters showed evidence of a return towards normal values, but at these times, and at day 28, values for RBC and FNCC remained significantly reduced in comparison with controls. At days 42 and 50 post-dosing, many haematological parameters in MMC-treated mice had returned to control levels; however, there remained evidence of late-stage effects on RBC, Hb and HCT values, and FNCC also continued to be significantly decreased. Results for granulocyte-macrophage colony-forming units and erythroid colonies showed a profound decrease immediately post-dosing, but a return to normal values was evident at day 50. Serum FL concentrations demonstrated very significant increases in the immediate post-dosing period, but a return to normal was seen at day 50 post-dosing; a relatively similar pattern was seen in the number of apoptotic femoral marrow nucleated cells. The histopathological examination of kidney tissues from MMC animals at day 42 and 50 post-dosing showed evidence of hydronephrosis with cortical glomerular/tubular atrophy and degeneration. It is therefore concluded that MMC administered on eight occasions over 18 days to female CD-1 mice at 2.5 mg/kg induced profound changes in haematological and bone marrow parameters in the immediate post-dosing period with a return to normal levels at day 50 post-dosing; however, there was evidence of mild but significant late-stage/residual effects on RBC and FNCC, and on cells of the erythroid lineage in the bone marrow.
丝裂霉素(MMC)与许多抗肿瘤药物一样,在人和实验动物中会引发可预测的、剂量相关的骨髓抑制;这种变化通常是可逆的。然而,有证据表明MMC也可能导致晚期或残留的骨髓损伤。本研究以雌性CD-1小鼠为对象,在一项为期50天的重复给药研究中,调查了MMC诱导的血液学和骨髓变化。对照组和接受MMC治疗的小鼠在18天内分八次腹腔注射赋形剂或2.5mg/kg的MMC,在最后一次给药后的1、7、14、28、42和50天进行解剖(n = 6 - 12),并调查血液学变化。还评估了股骨有核骨髓细胞计数和凋亡水平,并进行了集落形成试验;评估了血清FLT3配体(FL)水平。给药后第1天,MMC导致红细胞、血红蛋白和血细胞比容(HCT)值显著降低,网织红细胞、血小板和股骨有核细胞计数(FNCC)减少;中性粒细胞、淋巴细胞和单核细胞值也显著降低。给药后第7天和第14天,所有血液学参数均显示有恢复到正常值的迹象,但此时以及第28天,与对照组相比,红细胞和FNCC值仍显著降低。给药后第42天和第50天,接受MMC治疗的小鼠的许多血液学参数已恢复到对照水平;然而,仍有证据表明对红细胞、血红蛋白和HCT值有轻度但显著的晚期影响,FNCC也持续显著降低。粒细胞 - 巨噬细胞集落形成单位和红系集落的结果显示给药后立即显著下降,但在第50天明显恢复到正常值。血清FL浓度在给药后即刻显著升高,但在给药后第50天恢复正常;凋亡的股骨骨髓有核细胞数量呈现相对相似的模式。给药后第42天和第50天对MMC处理动物的肾脏组织进行组织病理学检查,显示有肾盂积水,伴有皮质肾小球/肾小管萎缩和变性。因此得出结论,在18天内分八次给雌性CD-1小鼠腹腔注射2.5mg/kg的MMC,在给药后即刻会引起血液学和骨髓参数的深刻变化,在给药后第50天恢复到正常水平;然而,有证据表明对红细胞和FNCC以及骨髓红系谱系细胞有轻度但显著的晚期/残留影响。