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Effect of nephrotoxic drugs on the development of radiation nephropathy after bone marrow transplantation. Int J Radiat Oncol Biol Phys 1994 Mar 01;28(4):883-9

Date

03/01/1994

Pubmed ID

8138441

DOI

10.1016/0360-3016(94)90108-2

Scopus ID

2-s2.0-0028300386 (requires institutional sign-in at Scopus site)   32 Citations

Abstract

PURPOSE: Chronic renal failure is a significant cause of late morbidity in bone marrow transplant patients whose conditioning regimen includes total body irradiation (TBI). Radiation is a major cause of this syndrome (bone marrow transplant nephropathy), but it may not be the only cause. These studies use a rat syngeneic bone marrow transplant model to determine whether nephrotoxic agents used in conjunction with bone marrow transplantation (BMT) could be enhancing or accelerating the development of radiation nephropathy.

METHODS AND MATERIALS: Rats received 11-17 Gy TBI in six fractions over 3 days followed by syngeneic bone marrow transplant. In conjunction with the bone marrow transplants, animals received either no drugs, cyclosporine, amphotericin, gentamicin, or busulfan. Drugs were given in schedules analogous to their use in clinical bone marrow transplantation. Drug doses were chosen so that the drug regimen alone caused detectable acute nephrotoxicity. Animals were followed for 6 months with periodic renal function tests.

RESULTS: Gentamicin had no apparent interactions with TBI. Amphotericin increased the incidence of engraftment failure, but did not enhance radiation nephropathy. Cyclosporin with TBI caused late morbidity that appeared to be due to neurological problems, but did not enhance radiation nephropathy. Busulfan resulted in a significant enhancement of radiation nephropathy.

CONCLUSION: Of the nephrotoxins used in conjunction with bone marrow transplantation only radiation and busulfan were found to be risk factors for bone marrow transplant nephropathy.

Author List

Lawton CA, Fish BL, Moulder JE

Author

Colleen A. Lawton MD Emeritus Professor in the Radiation Oncology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Amphotericin B
Animals
Bone Marrow Transplantation
Busulfan
Cyclosporine
Gentamicins
Kidney
Kidney Diseases
Male
Rats
Whole-Body Irradiation