Aplastic Anemia: Assessment of Myeloid Progenitor Cells in the Bone Marrow and Blood Provides Prognostic Information

Abstract

15 patients with aplastic anemia were prospectively followed after having measurements of myeloid progenitor cells in bone marrow and blood. Treatment included androgens, low or high dose steroids and standardized supportive care. The median length of survival was 5.8 months. When patients were grouped according to the numbers of myeloid progenitor cells present in their blood and bone marrow, we found that the survival length of aplastic patients with higher progenitor cell numbers was prolonged when compared to that of patients with lower numbers of these cells. The prognostic information obtained from such in vitro cultures was particularly indicative when the patients were grouped according to ‘growth’ and ‘no growth’: the absence of colony-forming myeloid stem cells was associated with survival times significantly shorter than those of patients whose cells maintained their colony-forming capacity. Besides initial numbers of myeloid progenitor cells, only initial numbers of granulocytes were related to survival length. Thus, the measurement of myeloid progenitor cells in bone marrow and blood can be of prognostic value in patients with aplastic anemia.

Patchy haemopoiesis in long‐term remission of idiopathic aplastic anaemia

“…Mild neutropenia and thrombocytopenia, observed in some of our patients, may relate to the decrease in haemopoietic progenitor cells in bone marrow, as pointed out by several investigators (2,(7)(8)(9). Since the number of progenitor cells assayed by the in vitro culture technique reflects the qualitative as well as quantitative status of stem cells, "no BFU-E colony growth" does not always mean an actual lack of stem cells but reflects a more qualitative abnormality of in vitro maturation (21). The results of bone marrow scintigraphy and bone marrow culture studies are markedly different from those of ferrokinetics in which more than half of our patients showed normal findings.…”

Treatment of Severe Aplastic Anemia with Combined Immunosuppression (Antithymocyte Globulin and High-Dose Methylprednisolone)

“…In spite of supportive measures, anabolics and low-dose steroids, 50% of the patients with SAA die within the first 6 months after diagnosis [1,2], Only 10-20% survive more than 2 years. In 1970, Speck et al [4] first described the beneficial effect of ATG in experimental animals and subsequently in patients suffering from SAA [5], The lack of a controlled study and poor results seen in other studies [12] prompted a prospective randomized trial to test the efficacy of ATG in a series of 42 patients with SAA [7).…”

“…The prognosis in severe aplastic anemia (SAA) treated only with supportive care is poor [1,2]. More than 50% of the patients die within 6 months and only about 10-20% may experience spontaneous improve ment or even cure.…”

Diagnostic and prognostic value of colony formation of hematopoietic progenitor cells in myeloid malignancies

“…Although semisolid colony assays are also useful for establishing a diagnosis in non-malignant diseases such as aplastic anemia and pure red cell aplasia [68][69][70][71][72], the main focus of the current review is on the diagnostic value of colony assays in acute myeloid leukemias (AMLs), myelodysplastic syndromes (MDSs), and myeloproliferative disorders (MPDs). Table 1 summarizes typical results of assessment of progenitor cells from peripheral blood in these diseases.…”