Aplastic anemia associated with bone marrow suppressor T‐Cell hyperactivity: Successful treatment with antithymocyte globulin

In five patients with idiopathic aplastic anemia, the colony‐forming unit (CFU‐c) assay was used to quantitate stem cells and test the possible presence of supressor cells inhibiting bone marrow differentiation. All five marrows failed to form CFU‐c. In one out of the five cases tested, coculture of the patient's marrow with normal marrow suppressed the latter to form CFU‐c. Removal of T‐cells from the patient's bone marrow freed the aplastic marrow to produce more colonies and, in the coculture study, abrogated its inhibitory activity on the normal bone marrow. Treatment of the patient with horse antihuman thymocyte globulin (ATG), improved the peripheral blood count and myelopoiesis. Furthermore, the aplastic marrow increased its colony forming capacity from < 1% pre‐ATG to 46% post‐ATG of the normal control, and its inhibitory activity on the normal marrow was ablated. In selected cases of aplastic anemia, with evidence of T‐suppressor cell hyperactivity, treatment with ATG may offer an alternative approach to bone‐marrow transplantation.

[1]  Nita Barrow,et al.  REPORT ON WORKSHOP A , 1978 .

[2]  N. Abdou,et al.  Suppressor cell-mediated neutropenia in Felty's syndrome. , 1978, The Journal of clinical investigation.

[3]  R. Hoffman,et al.  Suppression of erythroid-colony formation by lymphocytes from patients with aplastic anemia. , 1977, The New England journal of medicine.

[4]  R. Good.  Aplastic anemia--suppressor lymphocytes and hematopoiesis. , 1977, The New England journal of medicine.

[5]  P. Griner,et al.  Recovery from aplastic anemia after treatment with cyclophosphamide. , 1976, The New England journal of medicine.

[6]  R. Hoffman,et al.  Diamond-Blackfan syndrome: lymphocyte-mediated suppression of erythropoiesis. , 1976, Science.

[7]  J. Hébert,et al.  Suppressor T-cell abnormality in idiopathic systemic lupus erythematosus. , 1976, Clinical immunology and immunopathology.

[8]  S. Boggs,et al.  Editorial: The pathogenesis of aplastic anemia: a defective pluripotent hematopoietic stem cell with inappropriate balance of differentiation and self-replication. , 1976, Blood.

[9]  B. Speck,et al.  Autologous marrow recovery following allogeneic marrow transplantation in a patient with severe aplastic anemia. , 1976, Experimental hematology.

[10]  N. Abdou,et al.  Human bone marrow lymphocytes: B and T cell precursors and subpopulations. , 1976, Blood.

[11]  R. Storb,et al.  Recovery from aplastic anemia following attempted marrow transplantation. , 1976, Experimental hematology.

[12]  T. Waldmann,et al.  Impaired synthesis of polyclonal (non-paraprotein) immunoglobulins by circulating lymphocytes from patients with multiple myeloma Role of suppressor cells. , 1975, The New England journal of medicine.

[13]  R. Gershon.  A Disquisition on Suppressor T Cells , 1975, Transplantation reviews.

[14]  T. Waldmann,et al.  Role of suppressor T cells in pathogenesis of common variable hypogammaglobulinaemia. , 1974, Lancet.

[15]  M. Jeannet,et al.  Prolonged remission of severe aplastic anemia after ALG pretreatment and HL-A-semi-incompatible bone-marrow cell transfusion. , 1974, Transplantation proceedings.

[16]  P. Neiman,et al.  Allogeneic marrow grafting for treatment of aplastic anemia. , 1974, Blood.

[17]  Sensenbrenner Ll,et al.  Recovery of hematologic competence without engraftment following attempted bone marrow transplantation for aplastic anemia: Report of a case with diffusion chamber studies. , 1977 .

[18]  A. Steele,et al.  Recovery of hematologic competence without engraftment following attempted bone marrow transplantation for aplastic anemia: Report of a case with diffusion chamber studies. , 1977, Experimental hematology.

[19]  R. Good,et al.  Aplastic anaemia: Evidence for an immunological mechanism. , 1976, Lancet.

[20]  G. Santos.  Application of Marrow Grafts in Human Disease: Its Problems and Potential , 1972 .