Chemotherapy will definitely
cause bone marrow failure.
Again, a lot of what we are doing is generating
or producing molecules in chemotherapy
that will break DNA, or that
will inhibit normal cell turnover
by impacting our ability to repair DNA.
And if we do that to a tumor, it
may become so weird and so defective
in terms of its genome that
it dies, and that's the goal.
But then every other rapidly turning over cell in
the body - bone marrow, hair follicles, GI tract,
those are also going to be
susceptible to the same things.
And here we're just looking at a marrow
that has been completely ablated.
There should be a lot of cellularity in there,
and all we have is some residual macrophages.
We have a few blood cells and mostly fat.
There are no hematopoietic elements.
So this patient is going to be impressively
at risk for anemia, thrombocytopenia,
no platelets, so bleeding, but most profoundly
neutropenia and susceptible to infections.
Chemotherapy also affects other tissues.
Another area where there's rapid cell
turnover is in the production of sperm.
So we are looking at seminiferous
tubules, where there should be a robust
generation and differentiation of
the early spermatogonia into sperm.
And basically there's nothing left.
The circle is around, maybe two lonely little
sperms and the rest of the normal architecture
within that seminiferous tubule has been
ablated because of the chemotherapy,
so patients will be sterile.