Abstract
Chemotherapy and radiation therapy are associated with increased formation of reactive oxygen species and depletion of critical plasma and tissue antioxidants. In patients undergoing high-dose chemotherapy, the plasma antioxidant concentration has been shown to decrease. However, these studies in which the oxidative stress status were investigated have a small number of patients and they are heterogeneous. In this study, the changes in certain trace elements together with oxidative stress parameters were investigated in 36 patients who had undergone autologous stem cell transplantation because of solid and hematological malignancies. Blood samples of the patients were examined before the high-dose chemotherapy (baseline), before stem cell transplantation (day −1), and after stem cell transplantation on day 1, 3, and 6. Erythrocyte zinc, silver, and iron levels were measured by atomic absorption spectrophotometry; malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) levels were measured by UV-vis spectrophotometry.
After high-dose chemotherapy, significant increases in the levels of MDA, GSH-Px, and SOD were observed. On the other hand, Cu levels remained the same while the levels of erythrocyte Zn and Fe were increased. Significant correlation was observed among MDA, GSH-Px, and SOD (p<0.05). High-dose chemotherapy gives rise to an increase in the oxidative stress and the reactive oxygen species. Standard parenteral nutrition protocols were found to be insufficient to lower this stress.
Access this article
We’re sorry, something doesn't seem to be working properly.
Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.
Similar content being viewed by others
References
J. A. Knight, Free radicals: their history and current status in aging and disease, Ann. Clin. Lab. Sci. 28, 331–346 (1998).
S. Toyokuni, Reactive oxygen species-induced molecular damage and its application in pathology, Pathol. Int. 49, 91–102 (1999).
J. Hopkins and G. R. Tudhope, Glutathione peroxidase in human red cells in health and disease, Br. J. Haematol. 25, 563–575 (1973).
J. Nève, Methods in determination of selenium states, J. Trace Elements Electrolytes Healt. Dis. 5, 1–17 (1991).
N. W. Alcock, Trace elements, in Clinical Chemistry, 3rd ed., L. A. Kaplan and A. J. Pesce, eds., Mosby-YearBook, St. Louis, MO, p. 746 (1996).
J. Aaseth and T. Norsth, Copper, in Handbook on the Toxicology of Metals, L. Friberg, G. F. Nordberg, and V. B. Vouk, eds. Elsevier, New York, Vol. II, pp. 233–249 (1986).
J. H. Kramer, T. Mak, and W. B. Weblicki, Differential sensitivity of canine cardiac sarcolemmal and microsomal enzymes to inhibition by free radical induced lipid peroxidation, Circ. Res. 55, 120–124 (1984).
N. I. Weijl, F. J. Leton, and S. Osanto, Free radicals and antioxidants in chemotherapy-induced toxicity, Cancer Treat. Rev. 23, 209–240 (1997).
P. Sangeetha, U. N. Das, R. Koratkar, et al., Increase in free radical generation and lipid peroxidation following chemotherapy in patients with cancer, Free Radical Biol. Med. 8, 15–19 (1990).
M. Durken, J. Agbenu, and B. Finckh, Deteriorating free radical-trapping capacity and antioxidant status in plasma during bone marrow transplantion, Bone Marrow Transplant. 15, 757–762 (1995).
B. H. Lauterburg, T. Nguyen, B. Hartmann, et al., Depletion of total cysteine, glutathione, and homocysteine in plasma by ifosfamide/mesna therapy, Cancer Chemother. Pharmacol. 35, 132–136 (1994).
M. R. Clemens, C. Lander, and H. Schmidt, Decreased essential antioxidants and increased lipid hydroperoxides following high-dose radiochemotherapy, Free Radical Res. Commun. 7, 227–232 (1989).
C. Ladner, G. Ehninger, K. F. Gey, et al., Effect of etoposide (VP16-213) on lipid peroxidation and antioxidant status in a high-dose radiochemotherapy regimen, Cancer Chemother. Pharmacol. 25, 210–212 (1989).
A. Hunnisett, S. Davies, J. McLaren-Howard, et al., Lipoperoxides as an index of free radical activity in bone marrow transplant recipients, Biol. Trace Miner. 47, 125–132 (1995).
H. Faure, C. Coudray, and M. Mousseau, 5-Hydroxymethyluracil excretion, plasma TBARS and plasma antioxidant vitamins in adriamycin-treated patients, Free Radical Biol. Med. 20, 979–983 (1996).
J. R. Mitchell, C. V. Smith, H. Hughes, et al., Overview of alkylation and peroxidation mechanisms in acute lethal hepatocellular injury by chemically reactive metabolites, Semin. Liver Dis. 1, 143–150 (1981).
V. Bhuvarahamurthy, N. Balasubramanian, and S. Govindasamy, Effect of radiotherapy and chemotherapy on circulating antioxidant system of human uterine cervical carcinoma, Mol. Cell Biochem. 158, 17–23 (1996).
M. R. Clements, C. Ladne, and G. Ehninger, Plasma vitamin E and β-carotene concentrations during radiochemotherapy preceding bone marrow transplantation, Am. J. Clin. Nutr. 51, 216–219 (1990).
A. Meister, Glutathione deficiency produced by inhibition of its synthesis and its reversal: applications in research and therapy, Pharmacol. Ther. 51, 155–194 (1991).
A. Aydin, H. Orhan, A. Sayal, et al., Oxidative stress and nitric oxide related parameters in type II diabetes mellitus: effects of glycemic control, Clin. Biochem. 34, 65–70 (2001).
S. K. Jain, Hyperglycemia can cause membrane lipid peroxidation and osmotic fragility in human red blood cells, J. Biol. Chem. 264, 21,340–21,345 (1989).
J. Kalra, S. V. Mantha, and K. Prasad, Oxygen-free Radicals: key factors in clinical diseases, Lab. Med. Int. 1, 16–21 (1994).
M. Prazny, J. Skrha, and J. Hilgertova, Plasma malondialdehyde and obesity: is there a relationship? Clin. Chem. Lab. Med. 37(11/12), 1129–1130 (1999).
J. C. Doussent, M. Trouilh, and M. J. Foglietti, Plasma malonaldehyde levels during myocardial infarction, Clin. Chem. Acta 129(3), 319–322 (1983).
T. M. Bray and W. J. Bettger, The physiological role of zinc as an antioxidant, Free Radical Biol. Med. 8(3), 281–291 (1990).
C. R. Jonas, A. B. Puckett, D. P. Jones, et al., Plasma antioxidant status after high-dose chemotherapy: a randomized trial of parenteral nutrition in bone marrow transplantation patients, Am. J. Clin. Nutr. 72(1), 181–189 (2000).
L. Pironi, E. Ruggeri, and C. Zolezzi, Lipid peroxidation and antioxidant status in adults receiving lipid-based home parenteral nutrition, Am. J. Clin. Nutr. 68, 888–893 (1998).
J. Neuzil, B. A. Darlow, T. E. Inder, et al., Oxidation of parenteral lipid emulsion by ambient and phototherapy lights: potential toxicity of routine parenteral feeding, J. Pediatr. 126, 785–790 (1995).
O. Pitkanen, M. Hallman, and S. Anderson, Generation of free radicals in lipid emulsion used in parenteral nutrition, Pediatr. Res. 29, 56–59 (1991).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cetin, T., Arpaci, F., Yilmaz, M.I. et al. Oxidative stress in patients undergoing high-dose chemotherapy plus peripheral blood stem cell transplantation. Biol Trace Elem Res 97, 237–247 (2004). https://doi.org/10.1385/BTER:97:3:237
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1385/BTER:97:3:237