| Hematopoietic Blood Stem Cell Transplantation (HBSCT) is widely used in treatment of hematologic malignancies and solid tumors. But HBSCT is limited by the toxicity to the patients induced by the high-dose chemo/radiotherapy used as pretreatment in HBSCT. There are data to suggest that oxygen-derived free radicals and lipid peroxidation products may mediate tissue injury or damage. Suppose we can inhibit the generation of free radicals,then the toxicities will be maximal reduced and the tolerance of tissue will be improved greatly,thereby the organs may work well and the mortality of HBSCT patients may be decreased effectively. In the present work,the redox status of the HBSCT patients with or without supplementing antioxidant vitamins were detected,the relativity of the antioxidant capacities and the transplant-related toxicities were investigated,too.20 HBSCT patients were randomly divided into 2 groups. The supplemented group was given Vit C (300 mg/d) and Vit E (600 mg/d) for 15 days before the pretreatment of HBSCT,and the control group was given nothing. The levels of TAG,Vit C,Vit E,UA,MDA in plasma,the concentration of Fe2+ in serum,the activity of GSH-Px in blood and RBC-SOD were detected. The comparisons of the above index between the HBSCT patients and healthy control demonstrated that the chemo/ radiotherapy in pretreatment made the patients under high peroxide stress. Additionally,the occurrence,development and persisting time of OM and gastrointestinal effects after transplantation were observed and recorded in the patients with or without supplementing antioxidant vitamins. The results indicated that the occurrence,development and persisting time of OM and gastrointestinal effects after transplantation were decreased insupplementedgroup. The levels of BILx Cr and L-LDH in serum were monitored as organ toxicity indexes to show the effect between the patients with or without supplementing antioxidant vitamins.The results of our study demonstrated that:1. The HBSCT receivers were under heavy peroxide stress after pretreatment,and the concentration of Vit C,Vit E,UA and TAG in plasma declined by 46%,51%,36% and 41% respectively;MDA and serum iron rapidly increased by about 54% and 110% respectively;GSH-Px and RBC-SOD declined by 23% and 7% respectively. 2. Supplementing antioxidant vitamins before the pretreatment improved the antioxidant capability of HBSCT recipients:the average level of TAG in control group was 5.78 +1.11 U/ml,and the supplemented group was 8.00 + 1.34 U/ml,P<0.001;GSH-Px in control group was 95.06 + 8.90 U,and the supplemented group was 104.67 + 10.49 U,P<0.05. 3. The lipid peroxidation was decreased in supplemented group:the average level of MDA in control was 6.75 + 1.20 nmol/ml,and the supplemented group was 4.89 + 0.97 nmol/ml,P<0.001. 4. The decrease of RBC-SOD during HBSCT period was lessened in supplemented group:the maximum decrease of control group was 23% in comparison of 12% in supplemented group. 5. The supplemented group appeared to experience less OM,gastrointestinal toxicity and other organ toxicity:(the occurrence of OM:control group V5 supplemented group was 80% in comparison of 30%,P<0.05;the gastrointestinal effect:control group vs supplemented group was 80% in comparison of 30%,P<0.05;the occurrence of hyperbilirubinemia:control group vs supplemented group was 50% in comparison of 10%,P<0.05;the occurrence of high L-LDH in serum:control group vs supplemented group was 60% in comparison of 10%).The complex monitoring of the antioxidant status revealed a breakdown of body antioxidant defence in the HBSCT patients,the high-dose chemo/radiotherapy in pretreatment were closely related to the transplant-related toxicities. Antioxidant vitamins Supplementation beforeHBSCT obviously alleviated the heavy peroxide stress induced by high-dose chemo/radiotherapy,and some transplant-related toxicities are also reduced effectively too. So it may be used as a auxiliary treatment of HBSCT. |
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