Marrow‐Suppressing Factors in the Blood in Pure Red‐Cell Aplasia, Thymoma and Hodgkin's Disease

Field, E. O.; Caughi, M. N.; Blackett, N. M.; Smithers, D. W.

doi:10.1111/j.1365-2141.1968.tb01516.x

Cited by 39 publications

(4 citation statements)

References 26 publications

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“…Also, the return of normal erythropoiesis coincided with remission of the Hodgkin disease following treatment with multiagent chemotherapy. This case differed from most cases of pure red cell aplasia associated with lymphoproliferative disorders in the notable absence in our patient of any evidence of thymic tumor [2] . Investigation of the etiology of the severe anemia in our patient revealed the absence of erythropoietin activity and tlie presence in his serum of a potent inhibitor of erytliropoiesis which was shown to be an IgC.…”

Section: Discussioncontrasting

confidence: 94%

Hodgkin disease and red cell aplasia

1978

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A teenage boy with mixed-cellularity Hodgkin disease presented with severe anemia secondary to pure red cell aplasia of marrow without evidence of lymphomatous infiltration or hemolysis. In vitro studies of the patient's serum demonstrated an inhibitor of erythropoietin activity which appeared to be an IgG but which did not directly bind erythropoietin. The patient's anemia resolved and the inhibitor disappeared following chemotherapy for Hodgkin disease. Presumably, the inhibitor was directed at a very early stage of red blood cell production. This phenomenon may be related to other autoimmune manifestations occasionally seen in patients with lymphomas. The case is presented to bring attention to the unusual occurrence of red cell aplasia in Hodgkin disease. Several hypotheses concerning significance and etiology of the anemia are detailed.

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Section: Discussioncontrasting

confidence: 94%

Hodgkin disease and red cell aplasia

1978

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“…The mechanism for this tumor effect remains conjectural. The production of catabolic products of tumor, the secretion of physiologic inhibitors of erythropoiesis, or some form of metabolic competition have been previously postulated (13,22,23). A severe degree of bone marrow unresponsiveness to erythropoietin has been described in polycythemia vera, but not in chronic myelogenous leukemia (10,24).…”

Section: Discussionmentioning

confidence: 99%

Bone Marrow Erythropoiesis in the Anemia of Infection, Inflammation, and Malignancy

Zucker¹,

Friedman²,

Lysik³

1974

J. Clin. Invest.

102

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A B S T R A C T A major factor in the anemia of infection, inflammation, and malignancy is a relative failure of the bone marrow to increase erythropoiesis in response to a shortened red cell survival. The possible causes for this diminished marrow response are: (a) a reduced production of erythropoietin, or, (b) impaired bone marrow response to erythropoietin. In this report studies were performed on 6 normals, 13 patients with anemia from infection or inflammation, and 18 patients with anemia caused by advanced malignancy. Serum erythropoietin activity was measured using the posthypoxic, polycythemic mouse assay. Assessment of bone marrow response to erythropoietin was made by measuring '9Fe-heme synthesis in bone marrow suspensions cultured for 3 days with and without the addition of erythropoietin. The results showed that marrow heme synthesis was increased in erythropoietin-treated cultures as compared with saline control cultures by 66± 8% (mean +SE) in normals, 101±10% in patients with infection or inflammation, and 31±5% in malignancy.Serum erythropoietin levels were consistently diminished relative to expected levels for the degree of anemia in the infection-inflammatory group, but not in malignancy.In these patients, plasma inhibitors to the biological activity of erythropoietin were not detected in vitro.These studies suggest that another factor to consider in the anemia of malignancy is a decreased bone marrow response to erythropoietin. In the anemia of infectioninflammation, marrow response to erythropoietin is normal, but serum levels of erythropoietin are decreased relative to the degree of anemia.

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“…After initiation of chemotherapy, concurrent with normalization of all hormone levels, the patient regained hematologic remission without anabolic steroids. At the time of progressive disease and hormonal relapse she again developed severe anemia 6. Platelet values (pl) from five rats k 1 SEM before and after injection of heat inactivated pretreatment patient serum (0) and from five rats 2 I SEM before and after injection of heat inactivated normal control serum (0).…”

Section: Experimental Designmentioning

confidence: 99%

Pancreatic islet cell carcinoma associated with multiple hormone secretion and pancytopenia. Evidence of a serum factor suppressing hematopoiesis

Aabo

Romond

Dimitrov

et al. 1983

Cancer

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A case of metastatic islet cell carcinoma of the pancreas associated with the production of multiple polypeptide hormones (insulin, glucagon, and gastrin) is described. Three years prior to the histologic diagnosis the patient presented with a gastric ulcer and an androgen responsive pancytopenia with hypoplastic bone marrow. Discontinuation of androgen therapy resulted in relapse of pancytopenia. After the diagnosis of islet cell carcinoma of the pancreas was established, the patient was treated with 5‐fluorouracil (5‐FU) and streptozotocin and subsequently elevated serum polypeptide hormones returned toward normal levels. Concurrent with the normalization of peptide hormones another complete hematologic remission was achieved without use of androgens. Injection of the patient‐s serum into female rats produced a significant fall in leukocyte (P < 0.02) and platelet counts (P < 0.005), but no significant decrease in hematocrit. The clinical course and laboratory findings in this case suggest the presence of a previously undescribed serum factor released by an islet cell tumor capable of suppressing hematopoiesis.

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Marrow‐Suppressing Factors in the Blood in Pure Red‐Cell Aplasia, Thymoma and Hodgkin's Disease

Cited by 39 publications

References 26 publications

Hodgkin disease and red cell aplasia

Hodgkin disease and red cell aplasia

Bone Marrow Erythropoiesis in the Anemia of Infection, Inflammation, and Malignancy

Pancreatic islet cell carcinoma associated with multiple hormone secretion and pancytopenia. Evidence of a serum factor suppressing hematopoiesis

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