Use of bone-marrow culture in prediction of acute leukaemic transformation in preleukaemia
Francis, G.E.; Wing, M.A.; Miller, E.J.; Berney, J.J.; Wonke, B.; Hoffbrand, A.V.
Lancet 1(8339): 1409-1412
1983
ISSN/ISBN: 0140-6736 PMID: 6134182 Document Number: 199435
Bone-marrow granulocyte-macrophage progenitor cell proliferation and regulatory factor (colony-stimulating activity, CSA) production were assessed at presentation and, if possible, subsequently in 21 patients with dysmyelopoiesis and < 5% bone-marrow blasts. Seven patients underwent acute leukemic transformation 1-35 mo. after the 1st marrow culture. Assay of bone marrow endogenous CSA proved the most useful prognostic test. Rate of transformation in the 7 patients with raised CSA at presentation was significantly greater (5 transformed and 1 died at or before 4 mo.) than that in the 14 patients with normal, low or undetectable CSA (2 transformed at 27 and 35 mo.) In 1 of the latter, an increase in bone marrow CSA occurred 6 wk before transformation (serial marrow samples were not available in the other case). No other marrow culture feature measured, including the presence or absence of granulocyte-macrophage colony-forming cells and total clone numbers (colonies and smaller clusters), was as useful.