Hematopoietic Dysfunction Resulting from Antineoplastic Therapy: Current Concepts and Potential for Management

As is well known, the systemic administrationof chemotherapeutic agents or the application of large field irradiation results in cytotoxic effects. Specifically, this cytotoxicity is seen earliest and most clearly in rapidly proliferating tissue, whether normal or neoplastic. Although the bone marrowis not the only rapidly proliferating normal tissue, cytotoxic effects in the bone marroware easily quantified since declines in circulating levels of granulocytes, platelets, and reticulocytesare easily measured and more often than not directly reflect the extent to which any antineoplastic therapy has acutely impaired the ability of the bone marrowto function. In practice, hematologic toxicity as defined by declines in hemoglobin, leukocytes, granulocytes, platelets, and to a lesser degree reticulocyteshas become the dose limiting clinical parameter for guiding the administration of systemic antineoplastic therapy [1].