Potential pharmacological interventions against hematotoxicity: an overview

Abstract

Various treatment regimens, including chemotherapy, are known to induce heavy oxidative stress on the system, which in turn leads to adverse effects on healthy tissues. Blood being prone to oxidative stress is affected the most. At this juncture, it might not be prudent to anticipate having chemotherapeutic agents with no hematotoxicity; the best way forward is to look for potential anti-hematotoxic compounds, which could be supplemented to exposed patients, thus reducing the toxic burden on blood cells. We mined existing literature for reviewing possible interventions against hematotoxicity and figured that there is a great lacuna in this field in terms of not having such useful information at one place. This review presents the possible entities based on their antioxidant potentials, including their mechanistic pathways.

Keywords:

• anti-hematotoxic
• cancer
• chemotherapeutic
• hematotoxicity
• oxidative stress

Acknowledgements

Writing assistance was utilized in the production of this manuscript and was performed by A Nazir, Scientist, Division of Toxicology, CSIR-Central Drug Research Institute, Lucknow and the authors acknowledge his valuable suggestions and corrections in the manuscript. This is CSIR-CDRI Communication Number 4854.

Financial & competing interests disclosure

P Shukla thanks Department of Science and Technology, New Delhi, for providing Inspire fellowship as scholarly grant (IF 10507). RK Singh appreciates support from Director, CSIR-CDRI, Lucknow. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Hematotoxicity arises due to various factors, including chemotherapy.

• Majority of the chemotherapy agents induce a very high amount of oxidative stress on the system, leading to death of cancer cells.

• Blood being very prone to any assault, is easily affected, leading to hematotoxicity.

• Presently, erythropoietin and other hematopoiesis-stimulating agents are used as supportive therapies in cancer-associated anemia and other complications. Their use does not fulfill all criterions as supportive therapy regimens.

• There is a wide range of plant-based pharmacological interventions (PI) that have been proven to have blood-enhancing potential. It is speculated that PI with such a role may be useful in counteracting the cancer-associated toxicities, with nearly no complications.

• The PIs elucidated have antioxidant properties, which make them a substantial candidate to be used along with cancer therapy drugs.

• PIs reviewed here are hypothesized to inhibit the associated hematotoxicity without interfering with the normal therapeutic role of the drug.

• Some of the PIs have already been tested with anticancer drugs and have been reported to ameliorate the associated toxicity successfully.