Effect of hemopoietic growth factors on long-term marrow culture from patients with aplastic anemia

الملخص EN

Objective : the long-term marrow culture (LTMC) system provides an in-vitro physiological model for the study of stromal cell mediated hemopoiesis in patients with aplastic anemia.

The two aspects of hemopoiesis-stromal and stem cell function - can be studied using LTMC.

Addition of exogenous hemopoietic growth factors to LTMC can predict, to some extent, the result of administering such factors in-vivo as therapeutic drugs.

This work aimed at studying the effect of some different important hemo-poietic growth factors on LTMC of aplastic anemia patients.

Design and methods : the plan of this work was to evaluate the effect of SCF, IL3, GM-CSF, and G-CSF on LTMC of 19 newly diagnosed pediatric patients suffering from aplastic anemia.

The loss of LTC-IC was assessed weekly in the presence of these different cytokines.

Results : LTMC study has demonstrated severely reduced generation of CFUs in patients with aplastic anemia at diagnosis, with no detectable hemopoiesis beyond 4 weeks of culture in 10 / 19 cases.

There was a highly significant difference between the number as well as the maintenance of CFUs in LTMC between the controls and the aplastic anemia cases (p < 0.0001).

Conclusion : these results show that hemopoietic growth factors can partially maintain and support the proliferation and differentiation of primitive cells of some cases of aplastic anemia patients for only short period of time in LTMC.

Since routinely used concentrations and combinations of hemopoeitic growth factors, early acting as well as differentiating factors are currently not considered one of the regular therapeutic options in aplastic anemia, further studies using escalated concentrations of different combinations of growth factors might be tried to evaluate their exact role.

We suggest that the best curative treatment up till now would be allogenic bone marrow transplant (BMT) from normal donor.