Pathophysiology of chronic myelogenous leukemia--effects of mature granulocytes on erythroid colony formation in vitro
Urushiyama, M.
Nihon Ketsueki Gakkai Zasshi Journal of Japan Haematological Society 49(5): 1013-1023
1986
ISSN/ISBN: 0001-5806 PMID: 3466506 Document Number: 283728
To clarify the mechanisms of anemia in chronic myelogenous leukemia (CML), clinical features and hemopoietic precursors were analyzed in thirty-six patients with CML. In addition, effects of granulocytes on erythroid colony formation in vitro were examined. All patients studied had marked leukocytosis and most of them had also thrombocytosis, while half of these patients were anemic. No patients had erythrocytosis. The analysis of clinical data showed that anemia did not resulted from iron deficiency except in seven patients. In vitro stem cell assay demonstrated that the numbers of granulocyte-macrophage (CFU-c), erythroid (BFU-e and CFU-e), megakaryocyte (CFU-M), and pluripotenital (CFU-Mix) progenitors were increased both in the bone marrows and especially in the peripheral blood in patients with CML. In addition, the sensitivity of erythroid precursors (CFU-e) to erythropoietin (Epo) in two patients studied in vitro appeared to be normal. These data suggest that anemia in CML is not associated with the quantative or qualitative impairment of erythroid stem cells. However, there was an inverse correlation between leukocyte count and hemoglobin concentration in male patients. In addition, high concentrations of granulocytes or their conditioned medium added in culture were found to inhibit erythroid colony formation in vitro. These clinical and experimental results suggest that a remarkable increase of mature granulocytes in CML affects the erythroid maturation and cause ineffective erythropoiesis in vivo.