The effect of neoadjuvant chemotherapy on the level of bone marrow progenitor cells in the blood of patients with invasive breast carcinoma

Abstract

The breast cancer occupies the first place in the structure of women cancer morbidity and mortality for many years. The treatment of this pathology includes two types of chemotherapy: neoadjuvant and adjuvant. Neoadjuvant chemotherapy (NACT) follows surgical treatment and makes it possible to assess the sensitivity of the tumor to the medication. The obtained data can be used to correct the subsequent adjuvant chemotherapy. However, there is a lot of evidence of the ability of NACT to increase the risk of progression of malignant tumors. The bone marrow progenitor cells are components of premetastatic niches. Objective: to assess the effect of neoadjuvant chemotherapy on the level of bone marrow progenitor cells in the blood of patients with breast cancer. In a prospective study were included 31 patients newly diagnosed with invasive breast cancer, of which 17 patients was performed neoadjuvant chemotherapy, 14 patients - without neoadjuvant chemotherapy. The method of multicolor flow cytometry was used to assess the dynamics of bone marrow progenitor cells (hematopoietic stem cells (HSC) and hematopoietic progenitor cells (HPC), endothelial progenitor cells (EPC), mesenchymal stem cells (MSC) in blood of patients with invasive carcinoma of a non-specific type during NACT. It has been shown that neoadjuvant chemotherapy leads to a statistically significant increase the number of endothelial cell precursor cells (EPC) in the blood of patients with invasive breast carcinoma (p = 0.036). The level of mesenchymal stem cells in the blood of patients with invasive breast carcinoma increases at the level of a statistical trend (p = 0.06) during neoadjuvant chemotherapy. Based on these data we can conclude that neoadjuvant chemotherapy enhances the recruitment of bone marrow cells involved in the formation of premetastatic niches.