NABIH I. ABDOU, M.D., Ph.D.; JOSEPH D. VERDIRAME, M.D.; MAMMO AMARE, M.D.; NANCY L. ABDOU, M.D.
The mechanisms responsible for the bone marrow failure in 21 aplastic anemia patients were studied by the colony-forming units in culture assay (CFU-C). Twelve patients had no detectable in-vitro defect that could be responsible for the low CFU-C numbers. Three patients had suppressor T cells that inhibited CFU-C (p < 0.001); one of two patients responded to antithymocyte globulin therapy and the third recovered spontaneously. Three patients had serum inhibitory immunoglobulins directed against their marrow CFU-C; plasmapheresis resulted in recovery of bone marrow function. Three patients had abnormalities at the colony-stimulating factor level: Two had inhibitors of colony-stimulating factor, corrected in vitro and in vivo by indomethacin and cholinergic agonists (p < 0.01); and the third had colony-stimulating factor generation defect, corrected in vitro and in vivo by lithium. Testing for cellular or humoral suppressor factors directed against precursor cells or for abnormalities at the colony-stimulating factor level gives helpful guidelines to therapy in aplastic anemia.
ABDOU NI, VERDIRAME JD, AMARE M, ABDOU NL. Heterogeneity of Pathogenetic Mechanisms in Aplastic Anemia: Efficacy of Therapy Based on In-Vitro Results. Ann Intern Med. ;95:43–50. doi: 10.7326/0003-4819-95-1-43
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Published: Ann Intern Med. 1981;95(1):43-50.
Hematology/Oncology, Red Cell Disorders.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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