Transient pure red-cell aplasia: cell-mediated suppression of erythropoiesis associated with hepatitis.

Transient pure red-cell aplasia is a rare complication of persistent acute hepatitis. We have investigated possible mechanisms for marrow suppression in one such patient who developed erythroid aplasia in the course of transfusion-related hepatitis. The patient's lymphocytes, obtained during the acute illness, markedly inhibited erythroid colony formation by donor marrow. After the patient recovered, remission lymphocytes in co-culture did not inhibit colony formation. No reversible suppression was demonstrable by addition of patient serum. These observations suggest that hematocytopenias associated with hepatitis may result from cell-mediated suppression induced by hepatic injury.

Increased colony-stimulating activity in the plasma of a patient with lymphoepithelioma metastatic to the liver.

Leukocytosis with predominance of poly morphonuclear leukocytes is not unusual in a variety of primary or metastatic hepatic tumors. However, to date no apparent explanation for this event is available. This paper describes extreme leukocytosis in a 17-year-old black male with lymphoepithelioma after development of metastases to the liver. In order to identify the source of leukocytosis, studies of granulocytic colony-stimulating activity (CSA) of the patient's plasma and leukocyte-conditioned media (LCM) were carried out and compared with normal controls. The assay system consisted of nonadherent marrow cells of hematologically normal individuals and normal mice cultured in semi-solid culture media. In this system, the number of granulocytic colony-forming units (CFU-C) is proportional to the amount of stimulating activity present, and therefore allows for quantitative comparison. The number of colonies produced under the influence of patient's plasma was significantly higher (p less than 0.001) than those obtained from the patient's LCM or from control plasma or LCM. This pattern is the reverse of that seen in normal individuals in whom the major sources of CSA are macrophages and monocytes. It is conceivable that malignant cells are the source of additional CSA.

A comparison of granulopoiesis in culture from blood and marrow cells of nonleukemic individuals and patients with acute leukemia.

The objective of this study was to compare the concentration of committed granulopoietic progenitor cells (CFU-C) in marrow and blood. For individuals without leukemia, a highly significant correlation was observed between the concentration of CFU-C obtained from the two sites. However, CFU-C in blood had a slower sedimentation velocity than that reported for marrow and were found not to be in the DNA synthetic phase of the cycle using the tritiated thymidine suicide tehcnique. In patients with acute leukemia, no correlation was observed between concentrations of CFU-C in marrow and peripheral blood, regardless of whether the patients were newly diagnosed, in remission, or in relapse. We concluded that studies of the peripheral blood do not yield the same information in respect to granulopoietic progenitor cells as do studies of the marrow.