CHEMOTHERAPY-INDUCED BONE MARROW TOXICITY: MECHANISMS, CLINICAL IMPACT, AND MODERN PROTECTIVE STRATEGIES

Chemotherapy remains the backbone of systemic cancer therapy, but its non-selective cytotoxicity causes significant hematologic toxicity. Bone marrow suppression (myelosuppression) is among the most common and dose-limiting side effects, leading to anemia, leukopenia, and thrombocytopenia. This paper reviews the molecular mechanisms, clinical implications, and recent advances in preventing chemotherapy-induced bone marrow injury. Particular focus is given to hematopoietic stem cell (HSC) depletion, stromal niche disruption, and novel therapeutic strategies such as growth factor therapy, targeted delivery, and stem cell transplantation.