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Acquired aplastic anemia: Antibody‐mediated hematopoietic failure
Author(s) -
Freedman Melvin H.,
Gelfand Erwin W.,
Saunders E. Fred
Publication year - 1979
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830060205
Subject(s) - aplastic anemia , bone marrow , haematopoiesis , immunology , anemia , cfu gm , medicine , colony forming unit , stem cell , biology , bacteria , genetics
The hematopoietic failure in aplastic anemia was studied in six patients by assessing marrow erythroid stem cell (CFU‐E) and granulocytic stem cell (CFU‐C) colony growth in vitro. CFU‐E and CFU‐C were absent or reduced in five patients, and their serum did not inhibit CFU‐E or CFU‐C growth from control marrows. In contrast, marrow from one patient yielded 80 CFU‐E/10 5 and 16 CFU‐C/10 5 (control CFU‐E: 197/10 5 cells plated, range 110–387; control CFU‐C: 48/10 5 , range 15–106). His serum decreased CFU‐E (122 to 9/10 5 ) and CFU‐C (71 to 32/10 5 ) from control marrow, and CFU‐E from his own marrow (80 to 37/10 5 ). His peripheral blood lymphocytes cocultured with autologous or control marrow similarly decreased CFU‐C. The inhibition was more marked in cocultures using a B‐cell enriched lymphocyte fraction obtained by albumin density gradient centrifugation. IgG separated from the patient's serum demonstrated a dose‐responsive suppression of CFU‐E (102 to 8/10 5 ), and of CFU‐C (58 to 28/10 5 ) from control marrow. We conclude that of the six patients, one demonstrated an antibody‐mediated hematopoietic failure. It is recommended that all patients with acquired aplastic anemia be studied for this, since in vitro testing can detect those in whom immunosuppression and plasmapheresis may be more appropriate therapy than marrow transplantation.