Wistar-Lewis rats received therapeutic doses of doxorubicin or
methotrexate daily for five days, were pulse-labeled with a fluorescent
compound (calcein) on the seventh and thirteenth days, and were killed
fourteen days after initiation of the protocol. Proximal tail vertebrae
were then evaluated histomorphometrically, and the effects of the
chemotherapeutic agents on trabecular bone were quantitated with respect to
changes in total bone mass, new-bone formation, and resorption. Short-term
administration of methotrexate caused a 26.9 per cent reduction in net
trabecular bone volume and doxorubicin, an 11.5 per cent decrease. Both
drugs significantly and profoundly diminished bone-formation rates by
nearly 60 per cent. The toxic effect on osteoblasts was also reflected in
reduced volume and thickness of osteoid, but the total numbers of
osteoblasts and the per cent of trabecular surface covered by bone-forming
cells were not affected. The numbers of osteoclasts and the extent of their
activity were not clearly different from those in untreated rats, but rates
of resorption were not determined. The effects of chronic treatment with
these chemotherapeutic agents on intact, fractured, and transplanted bone
and the biomechanical significance of these changes has not yet been
evaluated. Clinical Relevance: Chemotherapeutic agents have an adverse
effect on normal physiological bone turnover, especially osteoblastic
activity, and would also be expected to alter fracture-healing and
bone-allograft incorporation by these same mechanisms. Knowledge of these
changes and efforts to favorably affect the remodeling cycle must address
these specific defects before bone allografts can be reliably used and
fracture-healing can be improved concomitant with chemotherapy.