Chromosome studies on lymphocytes of patients under cytostatic therapy

Summary Lymphocyte cultures from the peripheral blood of 38 patients undergoing a cytostatic interval therapy with a regimen of methyl-CCNU (1-[2-chloroethyl-3-(4-methyl-cyclohexyl)]-1-nitrosourea), 5-fluorouracil, and vincristine (each 5-day course of therapy was followed by a therapy interval of 4 weeks) were supplied with 5-bromodeoxyuridine (BUDR) for the whole culture time to determine the sister chromatid labelling pattern. From a total of 92 individual blood samples sister chromatid exchange (SCE) studies were performed including analyses before the start of the therapy, and immediately and 4 weeks after each course of therapy. In addition, the frequency of first, second, and third metaphases in the 72-h cultures was estimated using the characteristic labelling patterns.A distinct increase of SCE frequency over the control level (i.e., lymphocyte cultures of patients before the start of therapy) was observed at all phases of therapy. It was clearly correlated with the number of courses of therapy up to course 7, later on the SCE rate remained more or less at the level reached. The influence of the composition of each drug regimen on the SCE rate was less pronounced than it was on the breakage rate. Moreover, although a clear correlation existed between the individual rates of breakage and SCE, the formation of the latter appeared to reflect a long-term effect of the therapy rather than did the formation of break aberrations. In addition, as the intercellular variability of the number of SCEs per cell was much higher than that of breaks, the interindividual variability (variation of the mean values for each patient) was small compared to the respective variability of breakage rates.The proportion of first, second, and third metaphases present in 72-h cultures evidently was influenced by single courses of therapy. The observed delay of proliferation was also reflected in different amounts of chromosome damage. Although the BUDR treatment enhanced the cytostatic effect of the therapy on the lymphocytes in culture rendering SCE analysis rather difficult in several cases, the other data of this study and in particular the experiences with the long-term effect make it imperative to include BUDR-labelling in further cytogenetic studies in subjects with exceptional exposure to chemicals. However, the SCE method can by no means, replace the classic cytogenetic analysis.     

The effect of exposure fractionation on the yield of nondisjunctional segregation involving compound X and free 4-chromosomes in Drosophila

This paper describes the effect of fractionation of an exposure of 2000-R X-rays into two 1000-R exposures separated by a 3-h interval on the frequency of various segregation products following chromatoid interchange between a compound X and the 4th chromosome. It was observed that fractionation leads to a decrease of all exceptional progeny, the result being significant at the 0.05-probability level for both classes of detachments; i.e., with or without a 4th chromosome. The finding that the same effect of fractionation was observed for numerical aberration (non-disjunction) and detachment supports the idea that these reflect different consequences of the same primary effect, radiation-induced rearrangement. Furthermore, alternative recoveries were observed to occur at equal frequencies. Following C(1)-4 interchange, the univalent 4 does not segregate at random, but assorts apart from its homologue 1.5 as frequently as it moves to the same pole.     

Effect of treatment with dimethyl triazeno imidazole carboxamide (DTIC,NSC-45388) or 1,3-bis (2-chloroethyl)-1-nitrosourea (BCNU,NSC-409962) plus vincristine (NSC-67574) on lymphocyte reactivity of melanoma patients

Summary Fourteen patients with surgically incurable malignant melanoma treated with dimethyl triazeno imidazole carboxamide (DTIC) (2 mg/kg/day i.v. × 10) and 18 patients treated with the combination of 1,3-bis (2-chloroethyl)-1-nitrosourea (BCNU) (150 mg/m² i.v.) plus vincristine (2 mg/m² i.v.) on day 1 only, were tested for lymphocyte reactivity against melanoma cells before and after treatment. Neither chemotherapeutic regimen regularly affected lymphocyte reactivity, either in the presence of fetal calf serum or in the presence of the patients' autologous serum when tested 1 month after treatment. Three patients receiving repeated DTIC therapy and six patients receiving repeated BCNU plus vincristine therapy exhibited little variation in lymphocyte reactivity throughout the course of treatment.     

Analysis of chromosome aberrations in lymphocytes of long-term heavy smokers

We assessed the incidence of structural chromosome aberrations in 500 diploid first-division metaphases from 48-h lymphocyte cultures from each of 6 non-smokers and from 6 persons who had smoked a minimum of 1 pack of cigarettes per day for at least 20 years. Cytogenetic analyses of coded slides revealed a single dicentric chromosome with its accompanying fragment and two symmetrical chromatid exchanges in 3000 metaphases from the non-smokers. In contrast, 9 dicentric chromosomes, 8 translocations or inversions, and 7 chromatid exchanges were observed in 3000 metaphases from lymphocyte cultures from the 6 heavy smokers. A total of 13 metaphases having chromosome-type inter- or intra-changes was noted including 9 with a single aberration, and 4 with 2 or more. Our findings provide additional evidence of the in vivo clastogenicity of cigarette smoke in long-term heavy smokers, and further demonstrate that the distribution of chromosome-type exchange aberrations is overdispersed relative to that expected based on Poisson assumptions.     

Enhancement of the immune system of chemotherapy-treated cancer patients by simultaneous treatment with thymic extract,TP-1

Summary Thirty patients with incurable gastrointestinal cancer were treated in a randomized clinical trial, either with combination chemotherapy (5-fluorouracil, vincristine, and methyl-CCNU) or with the same chemotherapy and the thymic extract TP-1. T-lymphocyte counts slowly and steadily, increased in the TP-1-treated patients over a period of 4–5 months, in contrast to decreasing counts in the patients treated by chemotherapy only. The changes in both groups were significantly different from pretreatment counts (P<0.01). Skin tests for primary sensitization with DNCB were converted to positive or improved after TP-1 treatment (P<0.05 against control patients). In conclusion, TP-1 had a progressively accumulating effect on T-cell lymphopoiesis and activity (skin tests), which was strong enough to overcome chemotherapy-induced immunosuppression without any appreciable side effects.     

The rate of sister chromatid exchanges parallel to spontaneous chromosome breakage in Fanconi's anemia and to trenimon-induced aberrations in human lymphocytes and fibroblasts.

The incidence of structural chromosome aberrations and the rate of sister chromatid exchanges (SCE) was investigated in lymphocyte cultures from a patient with typical Fanconi's anemia and his parents. The rate of SCEs was found to be normal. In experiments with the alkylating agent Trenimon the SCE rates proved to be a sensitive indicator for the induction of structural aberrations: in presence of an induced aberration rate half as high as the spontaneous rate in the Fanconi's anemia case, the rate of SCEs was found to be quintupled. Dose-effect relationships for the induction of SCE rates by Trenimon were studied over a wide dose range in lymphocyte and fibroblast cultures. The results reflect the same difference in sensitivity earlier observed in the induction of structural chromosome aberrations, fibroblasts being far more sensitive.     

In vitro genotoxic effects of the anticancer drug gemcitabine in human lymphocytes

This research was carried out to investigate in vitro genotoxic effects of the anticancer agent gemcitabine on the induction of chromosomal aberrations and sister-chromatid exchange in human lymphocytes. Three doses of gemcitabine (0.001, 0.002 and 0.004 microg/ml) were applied to lymphocyte cultures from 15 donors. There was a significant increase in the induction of chromosome aberrations and in the occurrence of sister-chromatid exchange in these cells. In addition, gemcitabine significantly decreased the mitotic index and replicative index for all doses. Dose-response regression lines were used to compare the individual susceptibilities to gemcitabine with respect to the chromosome aberration and sister-chromatid exchange frequencies. Our results indicate that gemcitabine is able to induce both cytotoxic and genotoxic effects in human lymphocyte cultures in vitro in a dose-dependent manner.     

Damage susceptibility of human lymphocyte chromosomes at different stages of the mitotic cycle in combined exposure to fast neutrons and postradiation hyperthermia

The combined action of gamma rays (1-4 Gy) and postradiation hyperthermia on the human lymphocyte culture induces intensification of the damaging effect at the stage of DNA synthesis, i.e. at the most radioresistant stage of the mitotic cycle, the thermal intensification factor (TIF) being 1.7-2.0. After the neutron action (0.5-1.5 Gy) the hyperthermia has no effect on the chromosome aberration spectrum, the TIF being 1.8-2.5 at G1 phase and 1.8-2.4 at S phase, which testifies to the possible modification of neutron irradiation.     

Chromosome-breaking agent of low molecular weight in human systemic Lypus Erythematosus

Summary The serum of patients with systemic lupus erymathosus contains a chromosome-breaking agent of low molecular weight, which produces chromosomal breakage and rearrangement in lymphocyte cultures of healthy donors. This breakage factor is probably produced by or released from the cells of patients, since lymphocyte extracts and cocultivation of patients' lymphocytes with lymphocytes from healthy subjects results in an increased frequency of chromosome aberrations in the normal cells. The aberration rate induced by this clastogenic agent is reduced to normal values if the free radical scavenging enzyme superoxide dismutase is added to the culture medium at a final concentration of 0.05 mg/ml.     

Chromosome breakage in low birth weight newborns.

The frequency of chromosome aberrations in cells cultured from umbilical cord blood was determined for 50 low birth weight (LBW) and 50 normal birth weight (NBW) euploid newborns matched for sex, race, and maternal age. The metaphase spreads had been prepared in the course of an earlier study of frequency of aneuploidy and results are from 72-h cultures, i.e., presumably, at the second division in vitro. There were no significant differences between the two groups in the frequency of cells with chromosome breakage, chromosome gaps, or hyperdiploid cells. There was, however, a significantly higher frequency of hypodiploid cells in the LBW group. The present findings differ from those of others who have reported an increase in chromosome breakage in premature newborns.     

Cell selection in vivo

Summary A cytogenetic follow-up has been made of nine mixoploid children found among 11 148 consecutive newborn children.The frequency of the cell line with normal chromosomes increased in all but two, and the increase was statistically significant, being from 20% to 39% in four cases, and from 1% to 17% in three, while in one case there was no difference from the first to the last examination. The possibility that children with mixoploid chromosome abnormalities at birth will reveal no cell line with a chromosome abnormality in lymphocyte cultures as adults, despite having clinical signs of the chromosome aberration found in one cell line at birth is discussed, as is the question of cell selection in vivo.The mixoploid children had fewer clinical symptoms and fewer signs of the chromosome abnormalities found in some of their cells than children with the same chromosome abnormalities in all cells.     

On the localization of mitomycin C-induced aberrations in normal human and Fanconi's anaemia cells

This paper summarizes the results of a series of experiments with primary cultures of normal human fibroblasts and lymphocytes designed to investigate chromatid aberration 'break-point' localization after a 1-h pulse of mitomycin C. For discontinuities and interchanges, 60-70% of the inferred 'break-points' were localized to defined paracentric heterochromatin and the centromeric regions (i.e. approximately 21% by length of the normal karyotype), irrespective of 'dose', aberration frequency, sample time or cycle sub-phase as determined by replication banding. Chromatid intrachanges are non-(or negatively) localized because of an inescapable scoring bias. SCE in fibroblasts show no such localization. Cells from a number of Fanconi's anaemia subjects were examined. In poorly growing cultures, localization was as high as in normal cells but in vigorous cultures localization was reduced to approximately 30%. It is suggested that the enhanced aberration sensitivity of this syndrome could arise because non-localized aberrations, usually eliminated before division in normal cells, are allowed to reach mitosis in FA cells.     

Induction of chromosome aberrations in cultured human lymphocytes treated with ethoxyquin

The chromosomal aberration test was employed to investigate the effect in vitro of a known antioxidant and food preservative, ethoxyquin (EQ, 1,2-dihydro-6-ethoxy-2,2,4-trimethylquinoline) on human chromosomes. The studies were undertaken because there are no published in vitro data on genotoxicity of EQ in mammalian cells and there are many reports pointing out that it may be harmful to animals and human beings. Lymphocytes obtained from three healthy donors were incubated with EQ (0.01-0.5mM) both with and without metabolic activation. Stability studies performed by HPLC analysis showed that EQ was stable under the conditions of the lymphocyte cultures. The results of the chromosome aberration assay showed that EQ induces chromosome aberrations: gaps and breaks as well as dicentrics and atypical translocation chromosomes.     

cis-diamminedichloroplatinum(II)-induced sister-chromatid exchanges and chromosome aberration formation in cultured human lymphocytes and their inhibition by sodium thiosulfate

cis-Diamminedichloroplatinum(II) (cis-DDP)-induced sister-chromatid exchanges (SCEs) and chromosome aberration formation were studied in human lymphocytes. The mitotic index decreased abruptly at 2 X 10(-6) M cis-DDP and the frequency of SCEs was dose-related; a marked increase was recorded at 10(-6) M cis-DDP. A dose-dependent effect was also found for chromosome aberration formation at concentrations between 10(-11) and 4 X 10(-6) M. The aberrations observed were primarily chromatid breaks and gaps. We also examined the inhibition of these genotoxicities by treating the cells with sodium thiosulfate (STS). Simultaneous treatment with 10(-4)-10(-3) M STS (100-1000-fold molar ratio to cis-DDP) significantly reduced the frequency of SCEs induced by 10(-6) M cis-DDP. Furthermore, a 3-h delay in treating with STS significantly reduced cis-DDP-induced SCEs, but not chromosome aberration formation.     

A study of the relationship between chromosome anomalies and reproductive wastage in domestic animals

A cytogenetic survey was carried out on a partially unselected group of aborted foetuses, stillbirths/neonatal deaths and congenital defects originating from various domestic animals such as the feline, porcine, ovine, canine and bovine species. Chromosomes were analysed largely from fibroblast cultures of somatic tissue specimens received from different sources. Both fibroblast and lymphocyte cultures were simultaneously initiated whenever possible (e.g. from liveborns that had to be subjected to suthanasia as a result of debilitating phenotypic malformations).Forty-three and eight-tenths percent of the specimens cultured (i.e., 46 out of 105 specimens) could be adequately karyotyped. The overall incidence of chromosome anomalies was 8.7%, with mosaicism being the predominant observation. Because no gross chromosome abnormalities such as trisomy or polyploidy were found, it was concluded that any grossly abnormal foetuses might have already been selectively eliminated before the gestational stage at which this investigation was undertaken. The relatively low incidence of chromosome anomalies observed so far in various studies of domestic animals is discussed and compared to corresponding studies in humans.     

Cytogenetic analyses utilizing various clastogens in two sibs with Fanconi anemia,their relatives,and control individuals

Summary Structural chromosome damage, sister chromatid exchange (SCE), and proliferation kinetics were studied on lymphocyte cultures from the peripheral blood of two sibs exhibiting signs of Fanconi anemia, their relatives, and control individuals. While the rate of spontaneous chromosome breakage was at the lower limit of that known for Fanconi anemia in our patients, a distinctly greater increase than in controls of breakage frequency could be induced by isoniazid (INH), 4-nitroquinoline-1-oxide (NQO), and diepoxybutane (DEB) in their lymphocytes. Increased aberration frequencies as compared with controls were also observed in the clastogen-exposed lymphocyte cultures of the parents of both sibs, but in some experiments (NQO, DEB 24h) only in the cells of the healthy brother. There was an increase in the breakage rate of bromodeoxyuridine (BrdU)-labeled consecutive mitoses under the action of NQO, but a decrease with INH as the test clastogen.No significantly higher SCE frequency was found throughout the study in untreated and clastogen-exposed FA lymphocytes as compared with the respective controls. Proliferation was clearly inhibited by INH and NQO as indicated by a distinct increase of the percentage of BrdU-labeled first and a drastic decrease of third metaphases. The present test clastogens were shown not only to be suitable for ensuring the diagnosis of FA in patients with a low incidence of spontaneous breakage but also for determining clastogen-sensitive heterozygotes. According to these results cross-link repair cannot be the only mechanism affected by the basic defect of Fanconi anemia.Dedicated to Professor Dr. A. Barthelmess on the occasion of his 75th birthdayThis paper contains parts of the M.D. theses of D.K., H.M., and M.N.     

Clinical and cell kinetic data on the combination of cytosine arabinoside with daunorubicin, isosfamide, thioguanine, and vincristine for remission induction and maintenance in patients with acute myelocytic leukaemia (author's transl)]

31 adult patients (study A) with acute myelocytic leukaemia were treated for remission induction with cytosine arabinoside (ARA-C, 100 mg/m2/day) by a 7 (5) day continuous infusion. 3 (2) doses of daunorubicin (DNR, 45 mg/m2 i.v.) were added at daily intervals. For maintenance 5 day ARA-C was given monthly in sequential combination with DNR, thioguanine (TG), or ifosfamide (IFOS). 16 (52%) patients achieved complete remission (C.R.) after 1.8 (1-3) courses and 6.7 (3-10) weeks from treatment start. The median survival for responders and non-responders was 11.5 months, early death rate within 6 weeks was 3 (10%). Median remission duration was 13.5 months. Among 11 patients surving for 7-22 months 7 patients are in first remission for 5.5-20.5 months. DNR, IFOS and TG were given before the 3rd day of ARA-C infusion. In a previous group of 34 leukaemic patients and in 44 therapy courses DNA histograms of bone marrow cells using pulse cytophotometry showed marked accumulation in S-phase for 75% of courses. Also (G2 + M)-cells in the DNA distribution and thymidine pulse labelling indices were markedly increased in most cases, whereas thymidine uptake by scintillation counter was diminished and mitotic indices had not changed significantly. In now 15 patients (study B) the induction regimen was intensified by adding vincristine (VCR, 2 mg i.v.) and 3 doses of IFOS (600 mg/m2 i.v.). Preliminary results are 50% C.R. after 1,7 (1-2) courses and 6.8 (5-10) weeks from initiation of therapy. 2 patients died in the first 6 weeks.     

The analysis of chromosome lesions in lymphocytes of Hodgkin's lymphoma patients after chemotherapy and radiation therapy

The analysis of chromosome lesions in peripheral blood lymphocytes of Hodgkin's lymphoma (HL) patients after chemotherapy and chemotherapy with the subsequent course of radiation therapy is carried out. Is shown, that the mean aberration frequency was significantly higher in HL patients after chemotherapy (7.20 +/- 0.58 per 100 metaphases) than in non-treated HL patients (4.80 +/- 0.54, p < 0.01). The subsequent carrying out of radiation therapy enlarges number of chromosome aberrations on 100 metaphases up to 46.7 +/- 10.7 (p < 0.05), of which chromosome-type aberrations (43.2 +/- 10.3 on 100 metaphases) averaged 92.5%. In lymphocytes of 37 out of 43 HL antitumoral treatment patients, we found, in addition to ordinary aberrant cells, a large number of multiaberrant (MA-cells) cells, i.e. metaphases carrying multiple (at least four) chromosome-type exchange aberrations. In 30 non-treated HL patients only one MA-cell was found. From 171 MA-cells which were in 43 HL patients after antitumoral treatment, 114 MA-cells were found at inspection of 9766 diploid metaphases, and the remaining 57 MA-cells were found at inspection of 196 polyploid metaphases. The carrying out after chemotherapy of radiation therapy enlarges in lymphocytes frequency of appearance of MA-cells. The analysis of MA-cells in diploid and polyploid metaphases shown, that the MA-cells could be formed both in vivo, and in vitro in absence of influence of clastogenic factors, and could survive at least two rounds of in vitro replication.     

Cytogenetic investigation in lymphocytes of people living in cadmium-polluted areas

Chromosome aberrations were analyzed from peripheral lymphocyte cultures of 21 men and 19 women who had been exposed to environmental cadmium, and 11 controls (9 men and 2 women). The average cadmium level in the urine of the Cd-polluted group was 3.32 micrograms/l for men and 3.83 micrograms/l for women. There were significant differences in chromosome aberration frequencies between the Cd-polluted and non-polluted groups. The number of individuals with relatively high aberration frequencies (greater than or equal to 5%) in the Cd-polluted group was greater than in the controls. Individuals with a high cadmium content in urine (greater than or equal to 3 micrograms/l) had higher aberration frequencies and more severe aberration types in comparison with the low-cadmium group (less than 3 micrograms/l). There were significant correlations between chromosome aberration frequencies and urinary cadmium content (r = 0.463). The linear regression equation was determined. Considering the conflicting results in other published reports, it is hard to say that the conclusion that cadmium only acts synergistically to enhance the mutagenicity of other compounds present in the environment is correct. According to our study, environmental cadmium cannot only induce chromosome aberrations but also increases the chromosomal aberration frequencies and the frequency of severe aberration types.     

Experimental derivation of relative biological effectiveness of A-bomb neutrons in Hiroshima and Nagasaki and implications for risk assessment

Epidemiological data on the health effects of A-bomb radiation in Hiroshima and Nagasaki provide the framework for setting limits for radiation risk and radiological protection. However, uncertainty remains in the equivalent dose, because it is generally believed that direct derivation of the relative biological effectiveness (RBE) of neutrons from the epidemiological data on the survivors is difficult. To solve this problem, an alternative approach has been taken. The RBE of polyenergetic neutrons was determined for chromosome aberration formation in human lymphocytes irradiated in vitro, compared with published data for tumor induction in experimental animals, and validated using epidemiological data from A-bomb survivors. The RBE of fission neutrons was dependent on dose but was independent of the energy spectrum. The same RBE regimen was observed for lymphocyte chromosome aberrations and tumors in mice and rats. Used as a weighting factor for A-bomb survivors, this RBE system was superior in eliminating the city difference in chromosome aberration frequencies and cancer mortality. The revision of the equivalent dose of A-bomb radiation using DS02 weighted by this RBE system reduces the cancer risk by a factor of 0.7 compared with the current estimates using DS86, with neutrons weighted by a constant RBE of 10.