Chromosomal abnormalities in skin following total body or total lymphoid irradiation

Frequent induction of chromosomal aberrations in in vivo skin fibroblasts after allogeneic stem cell transplantation: hints to chromosomal instability after irradiation

Background

Total body irradiation (TBI) has been part of standard conditioning regimens before allogeneic stem cell transplantation for many years. Its effect on normal tissue in these patients has not been studied extensively.

Method

We studied the in vivo cytogenetic effects of TBI and high-dose chemotherapy on skin fibroblasts from 35 allogeneic stem cell transplantation (SCT) patients. Biopsies were obtained prospectively (n = 18 patients) before, 3 and 12 months after allogeneic SCT and retrospectively (n = 17 patients) 23–65 months after SCT for G-banded chromosome analysis.

Results

Chromosomal aberrations were detected in 2/18 patients (11 %) before allogeneic SCT, in 12/13 patients (92 %) after 3 months, in all patients after 12 months and in all patients in the retrospective group after allogeneic SCT. The percentage of aberrant cells was significantly higher at all times after allogeneic SCT compared to baseline analysis. Reciprocal translocations were the most common aberrations, but all other types of stable, structural chromosomal aberrations were also observed. Clonal aberrations were observed, but only in three cases they were detected in independently cultured flasks. A tendency to non-random clustering throughout the genome was observed. The percentage of aberrant cells was not different between patients with and without secondary malignancies in this study group.

Conclusion

High-dose chemotherapy and TBI leads to severe chromosomal damage in skin fibroblasts of patients after SCT. Our long-term data suggest that this damage increases with time, possibly due to in vivo radiation-induced chromosomal instability.

Clonal chromosome abnormalites found in three non-neoplastic proliferative brain lesions

Chromosome analysis was made of brain lesions from three patients which, according to classical histopathological criteria, did not contain tumor cells. In addition to normal cells, we identified abnormal karyotypes with clonal numerical and structural chromosome alterations in at least two independently originated primary cultures from each lesion. Our data suggest that chromosomal aberrations can exist in vivo in non-neoplastic lesions. Other abnormalities may be due to genetic instability manifested only in vitro (culture artifacts) or may already have been present in brain tissue, reflecting previous chromosome damage (as a result of exposure to chemical treatment or enviromental clastogens).

Therapy-related chromosomal changes and cytogenetic heterogeneity in human gliomas

The karyotypes of 18 primary 'untreated' gliomas, 6 recurrent gliomas treated with radiotherapy and/or chemotherapy and 2 gliomas before and after treatment are described, based on observations using standard cytogenetic techniques. In comparison to the untreated gliomas there were relatively consistent chromosome differences in the treated gliomas, including (1) deletions of the long arm of chromosome 7 with breakpoint at q22, possibly induced by alkylating agents, and (2) numerous single cell abnormalities or unrelated clones of structural abnormalities, presumably induced by radiotherapy.

Interrelationship between methodological choices and conceptual models in solid tumor cytogenetics

Scientific methods and models are interdependent. That the techniques one uses determine which findings one gets, is evident. But equally important is the influence of our a priori expectations; they may cause us to choose inadvertently those methods that are most likely to yield results that appear to confirm an already preconceived picture of reality. The conceptual models and methods of solid tumor cytogenetics are to a large extent inherited from leukemia and lymphoma cytogenetics. We illustrate how this may bias the generation and interpretation of new findings, especially when carcinomas are investigated. These malignant epithelial tumors much more often harbor cytogenetically unrelated clones than do hematologic or mesenchymal neoplasms. Carcinoma cytogenetics is therefore extremely susceptible to selection differences, making the results heavily dependent on which sample is processed, how it is disaggregated, how and for how long the cells are cultured, and on how the analysis is performed and the results presented. This calls for more efforts to be directed toward establishing also the phenotypic nature of those cells that are being karyotyped. As one cannot yet quality-grade most clonal chromosome changes in any reliable manner, meaning that one cannot determine to what extent each aberration or each clone contributes to the neoplastic process, statements about the "true" karyotypes of tumor parenchymas should be viewed with suspicion. A complete carcinoma karyotype may be much more complex than extrapolations from the analysis of a few cells may lead one to believe.