Abnormal colony formation and prostaglandin e responsiveness of myeloid progenitor cells in patients cured of germ cell neoplasms after combination chemotherapy
Quality of Health Care
Myelopoiesis was evaluated in 16 patients in complete remission for a minimum of 9 months after treatment with cisplatin-based combination chemotherapy for metastatic germ cell tumors. None had overt hematopoietic abnormalities. Bone marrow aspirates were obtained for routine morphologic evaluation in seven patients, and myeloid precursor cells were studied for both colony/cluster formation and sensitivity to prostaglandin E-(PGE) mediated growth inhibition in 13 patients. Routine stained marrow smears appeared normal. Six of 13 patients demonstrated abnormal colony/cluster formation. Four patients had no colony formation at all. Ten of 12 patients showed decreased sensitivity of granulocyte-macrophage colony-forming cells (CFU-GM) to PGE inhibition. The studies suggest that defects in myelopoiesis are detectable in patients treated for germ cell tumors with combination chemotherapy. The clinical significance of these findings requires long-term follow-up and surveillance for overt hematopoietic abnormalities in survivors of testicular cancer.