BrdU-Hoechst-ethidium bromide (EB) quenching technique for studying kinetics of hematopoiesis.
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Biomedical subjects
Publications and source records attributed to M E Peetermans.
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To assess the effects of GM-CSF in patients with myelodysplasia, a total of 101 patients with refractory anemia (RA), RA with ringed sideroblasts (RARS), and RA with an excess of blasts provided that the percentage of blasts in the bone marrow did not exceed 10% (RAEB) were enrolled in the EORTC Leukemia Cooperative Group study 06885. They were randomized to receive two daily subcutaneous injections of rhGM-CSF (mammalian, glycosylated, Sandoz/Schering-Plough) at a daily dose of either 108 micrograms glycoprotein (group I) or 216 micrograms glycoprotein (group II) for 8 weeks. Response was defined as an increase in Hb (greater than 2.5 g%), neutrophil count (more than 100%), or platelet count (more than 100%) without progression of the disease. After exclusion of 19 patients who did not meet the entry criteria, 82 were evaluated. Fifty-four patients (66%) responded (27 of 42 patients in group I and 27 of 40 in group II). Progressive disease was seen in two patients of group I and in four of group II. Two of the latter developed leukemia. All responses were reflected in the granulocytic series. In two patients platelet numbers also increased. Cytogenetic analysis, successfully performed in 43 cases, showed that 14 of 16 patients with normal karyotypes responded, compared with 14 of 27 patients with abnormal karyotypes (p = 0.008). In some cases GM-CSF was reduced in dose or discontinued prematurely due to side effects so that only 35% of all evaluable patients finished 8 weeks of treatment without a change of dose.
Random platelet concentrates were pooled and depleted of leucocytes by centrifugation immediately prior to transfusion. The incidence and severity of reactions to 570 leucocyte-poor platelet transfusions in 74 patients were studied. An overall transfusion reaction rate of 13.7% was observed. The reaction rate to platelets stored for less than 3 days (8.7%) was significantly different from the reaction rate to platelets stored for 3 days or more (17.6%). Minor reactions as well as moderate and severe reactions were more frequent in the latter group. As most of the white blood cells were removed prior to transfusion, it is suggested that the reactions result from the transfusion of pyrogenic and/or vasoactive substances accumulated in the plasma of the concentrate during storage.
Ki-67 is a commercially available monoclonal antibody that reacts with a nuclear antigen detectable in proliferating cells only. Since its first description, it has been widely used as a "universal" proliferation marker and few groups have questioned the validity of the initially described reactivity, although this was tested only on very restricted experimental models. We wanted to check its reactivity on normal bone marrow (BM) samples using a multiparameter flow cytometric analysis. Although we were able to reproduce the findings of Ki-67 positivity on cultured and stimulated cells, we could not detect any convincing Ki-67 positivity on nuclei of normal BM samples. These samples all had a noticeable proliferating compartment as evidenced by their DNA content. These data are in contrast with the data we obtained starting from stressed marrows and marrows cultured in the presence of hematopoietic growth factors, where we found a marked Ki-67 positivity. This discrepancy suggests that bone marrow cells, growing and proliferating under steady-state conditions and guided by natural control mechanisms, may lose their Ki-67 expression upon exiting the progenitor compartment and entering the differentiating compartment.
Blood group A antigen density on red blood cells (RBC) was studied using flow cytometry (FCM) and fluoresceinated polyclonal and monoclonal IgG anti-A antisera. Agglutination was a problem, which could only be solved by prefixation of the RBC with glutaraldehyde or formaldehyde. However, this treatment resulted in a significant reduction of the number of antigen sites as compared to the native (i.e. nonfixed) RBC. Two major new findings came out of this study: (1) A antigen density on native RBC seems to be higher than previously recognized, and (2) A antigen density distribution is probably non-Gaussian. The absolute number of A antigen sites was determined, using a human polyclonal IgG antiserum and commercially available absolute fluorescence standards. The site numbers on fixed RBC were comparable to those found by earlier radioimmunological studies (x 10(6)/RBC): A1, 1.07 +/- 0.28; A2, 0.21 +/- 0.09; A1B, 0.79 +/- 0.26 sites (mean +/- SD). The values found for native RBC were considerably higher (x 10(6)/RBC): A1, 2.86 +/- 0.95; A2, 0.47 +/- 0.29; A1B, 1.98 +/- 0.58 sites (mean +/- SD). With the 1 monoclonal and the 3 polyclonal antisera used in this study, and in contrast to Rh D, the erythrocytic A antigen density distribution of a given sample is highly asymmetrical. This non-Gaussian distribution profile does not seem to be affected by such factors as antibody heterogeneity, variability in antibody fluoresceination range, RBC density and reticulocyte content. This suggests that the asymmetrical A antigen distribution may be an intrinsic property of the RBC population.
An immunofluorescence study of the adherent layer of human long-term bone marrow cultures (HLTBMC) revealed the following surface markers on the different stromal cell populations: stromal fibroblastic cells CD10+, FIB86.3+, CD13+, CD71+; adipocytes CD10+, FIB86.3-, CD13+, CD71-/+; and macrophages CD10-/+, FIB86.3+, CD13+, CD71-/+, CD14+, CD33+, CD25+, HLA-DR+, CD4+, CD19+, CD45+. The markers of the stromal fibroblastic cells in HLTBMC were similar to those of twice-passaged fibroblasts not only from bone marrow and spleen, but also from a hemopoietic non-supportive organ such as the skin. Some of the cultured human umbilical vein endothelial cells used as controls were found to be CD25+, demonstrating for the first time the interleukin-2 receptor p55 chain on normal non-hemopoietic cells. The stromal fibroblastic cells are overrepresented compared to the small non-macrophage hemopoietic cell population in the adherent layer of HLTBMC. In addition, silver staining revealed an increased reticulin content in most of the HLTBMC. An excessive growth of stromal fibroblastic cells and an excessive deposition of their product, the reticulin fibers, are the hallmark of myelofibrosis. The finding of equivalent observations in HLTBMC suggests that the hitherto unexplained, premature quenching of hemopoiesis in HLTBMC might at least partly be due to mechanisms similar to those operating in myelofibrosis in vivo.
Pentostatin was used to treat 26 patients with advanced B-cell chronic lymphocytic leukemia resistant to conventional treatment. Twenty patients had progressive disease on previous regimens and six had had partial remission and then relapsed 3-34 months after previous chemotherapy. Eleven patients had previously been treated with three different regimens. 10 had been treated with two regimens, and five had been treated with one regimen. Pentostatin was administered at a dosage of 4 mg/m2 weekly for 3 weeks, then 4 mg/m2 every other week for 6 weeks and once a month for 6 months. Seven of 26 assessable patients (27%) achieved partial remission and five (19%) achieved clinical improvement. The median duration of partial remission until relapse or death was 210 days. Myelosuppression was minor and transient in responsive patients, indicating some degree of selective effect on lymphocytes. Except for one patient who died of cerebral hemorrhage during the first 6 weeks of treatment, no drug-related deaths were registered. Major toxic effects included nausea in 17 patients (mainly grade 1), infections in 15, and liver enzyme elevations in five. Thus, pentostatin is active, even in patients with advanced B-cell chronic lymphocytic leukemia that is refractory to multiple chemotherapy regimens. Response can be achieved with mild myelosuppression.
We describe a 26 year-old male with a pancytopenia possibly due to cimetidine. Using progenitor cell culture techniques we investigated the mechanism of this bone marrow toxicity. Our results show a cimetidine dose-dependent inhibition of normal human CFU-GM colony formation as described by Fitchen and Koeffler in 1980. No differences in growth inhibition were found between the patients' recovery marrow and the controls. Toxicity on normal human CFU-MIX colony formation was, however, far more pronounced. At concentrations as low as 5 micrograms/ml the numbers of CFU-MIX colonies were decreased by almost 20% and more than 30% in cultures of two normal bone marrow samples. A significant decrease in CFU-MIX colony size was measured even at therapeutic levels (0.5 micrograms/ml). No obvious decrease in CFU-GM colony size was noticed at low concentrations. Experiments with T-cell- and monocyte-depleted bone marrow samples gave similar results: a pronounced inhibition of the CFU-MIX colony formation at low concentrations of cimetidine whereas the CFU-GM formation was less affected. It is therefore very unlikely that Accessory cells play part in the cimetidine induced CFU-MIX inhibition. Our results suggest the existence of H2 histamine receptors on human CFU-MIX (= multipotent progenitor cell). Blocking these receptors prevents the multipotent progenitor cell from going into the DNA-synthesis phase of the cell cycle.
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Immunofluorescence microscopy of the adherent layer of human long-term bone marrow cultures (HLTBMCs) consistently revealed motility-associated features in a part of the plasma cells. Not only were small surface blebs observed, but also long extensions whose morphology was reminiscent of neuronal axons. The observations were made in all HLTBMCs established with normal as well as myelomatous bone marrow (BM). Plasma cells with long extensions were also noticed on May-Grünwald-Giemsa smears of original uncultured BM from normal individuals and patients with myelomatous disorders. This suggests that the motility-associated morphological features occur in vivo as well as in vitro. The observations were most striking in the one case of plasma cell leukemia, both in culture as well as in the BM smear.
We compared DNA fingerprints of different cell populations from the same individuals, after separate digestion with the isoschizomers MboI and Sau3A. Methylation differences were observed within every individual when comparing fingerprints of Sau3A- with MboI-digested DNA, and of Sau3A-digested sperm with somatic DNA. In some cases, differences were also detected between fingerprints of Sau3A-digested somatic DNA originating from various cell sources. Methylation patterns common to all cell populations examined, including the germline, were observed with a higher frequency than divergent ones. These 'common methylations' are most likely to find their origin during early embryogenesis.
We describe a case of severe sulfasalazine allergy. Exacerbation of the symptoms occurred after unintentional rechallenge with co-trimoxazole, indicating that the reaction was triggered by the sulphonamide component. The clinical picture consisted of generalised adenopathy, hepatitis, high fever and a maculopapular skin rash. A bone marrow biopsy and skin biopsy both showed noncaseating granulomas. The white blood cell count rose to 90.10(9)/l with 40% atypical lymphocytes (plasmacytoid). They were identified by flow cytometry as activated T lymphocytes.
Flow cytometric evaluation of reticulocytes has become a valuable and more precise alternative for the microscopically determined reticulocyte count. Until now, the most promising results are obtained with the "thiazole orange" (TO) nucleic acid dye. We report on the use of a "thiazole orange" analogue, 1,3'-diethyl-4,2'-quinolylthiacyanine iodide (DEQTC), which gives comparable results and is commercially available at low cost.
The quantitative evolution of endothelial cells (ECs) in Dexter-type human long-term bone marrow cultures (HLTBMCs) was investigated. Using monoclonal antibodies directed against von Willebrand factor (vWF) and against membrane antigens (EN-4 and PAL-E), a low percentage--usually less than 1% of stromal cells--of ECs was detected in all confluent cultures established from 11 different bone marrow samples. Generally these cells are not associated directly with the areas of myelopoiesis ("cobblestone areas"). ECs cannot be demonstrated in the adherent layer of most young, non-confluent, and of some old, HLTBMCs. In some instances, morphological features suggestive of dynamic behavior were seen (sprouting, canal formation). In addition, a very low proportion of vWF-positive megakaryocytic cells was found in 4 of 11 cultures, always in direct contact with the stromal fibroblastic cells.
An immunological analysis of the nonmacrophage hemopoietic cells in the adherent layer of human long-term bone marrow cultures was performed in situ. It revealed not only the expected granulocytic and monocytic cells, but an important lymphoid population as well. The latter consisted of cells bearing the markers of mature T lymphocytes, B lymphocytes, and plasma cells. These cells were also present in the hemopoietic foci of the adherent layer, the so-called cobblestone areas. Although more CD8+ than CD4+ lymphocytes were generally present in the initial bone marrow inoculum, both the adherent layer and the nonadherent fraction disclosed a preponderance of CD4+ cells after a short period of culture. The majority of the lymphoid cells were present in the adherent layer, rather than in the nonadherent fraction of the cultures. The long-term presence of lymphoid elements in the adherent layer suggests their affinity for the bone marrow stroma and the possible enhancement of their persistence in vitro by contact with these cells.
Human long-term bone marrow cultures (HLTBMCs) were established with bone marrow (BM) collected from five patients with myelomatous disorders (four with multiple myeloma, one with plasma cell leukemia). In all cases, up to at least 6 weeks of culture, there was a persistence of the monoclonal plasma cell population in the adherent layer of the culture. In some cultures proliferating plasma cells could be demonstrated by the Ki-67 monoclonal antibody. In all instances a paraprotein could be shown in the conditioned medium. This study demonstrates that malignant plasma cells, in analogy to their normal counterparts, have an affinity for the BM stroma and suggests that their long-term survival might be enhanced by their interaction with it.
Human long-term bone marrow cultures (HLTBMCs) were established from thawed post-cryopreservation, as well as from cadaver donor bone marrow (BM) samples. The longevity was similar in the different series of HLTBMCs examined. CFU-GM could be cultured out of cadaver donor BM. This indicates that previously healthy people, under the conditions generally accepted as suitable for organ donation, could become suitable donors for allogeneic BM transplantation.
An indirect immunofluorescence test using a platelet mononuclear cell suspension is described. The test is a simple and sensitive method to assess the contamination by anti-HLA antibodies of sera being tested for platelet reactivity and eliminates the need to support two independent test systems such as lymphocytotoxicity and immunofluorescence testing. The test could be of value in routine platelet serology testing and platelet crossmatching.