再生障碍性贫血骨髓细胞体外长期培养

LONG-TERM MARROW CULTURES IN PATIENTS WITH APLASTIC ANEMIA

骨髓细胞体外长期培养(long-term marrow culture,LTMC)可了解基质细胞及其分子产物对造血干细胞分化全过程中各阶段的调节作用。本文报道利用长期液体培养,观察再生障碍性贫血(下称再障)患者骨髓细胞体外生长规律及其临床意义,证实正常骨髓培养3～4周后皆形成基质细胞层,而再障患者中,9/11例培养后虽然可形成基质细胞层,但“鹅卵石”样区域较少且形态亦较小。2例培养后一直未形成基质细胞层。计数上清液中未粘附细胞及CFU-GM总数,发现正常对照及再障骨髓培养一周后非粘附细胞即渐下降,两者的下降率类似。正常对照骨髓平均接种CFU-GM为415/10~6MNC,随培养时间延长CFU-GM数亦渐减少,但可维持5周以上。再障患者骨髓的CFU-GM生长极少,7/11例从接种起一直未见CFU-GM生长,而1例初治慢性、2例经治疗好转和1例复发病人的骨髓接种时含有一定量的CFU-GM,在培养过程中亦可维持2～4周。认为LTMC更适于对再障发病机理的分析,从而对指导临床治疗有重要意义。

Long-term marrow cultures(LTMC) were initiated with marrow from 15 normal subjects and 11 patients with aplastic anemia (AA). The confluent adherent layer developed in all cultvires from normal controls and 9 AA cases. The cobblestone-like' areas in LTMC from AA cases were smaller than those from the controls. No stromal layer was observed in 2 AA cases. The decline of non-adherent cell (NAC) numbers in LTMC was similar for both aplastic cases and normal controls. Granulocyte-macrophage colony- forming units (CFU-GM) in NAC from normal LTMC could be maintained at least 5 weeks, while CFU-GM in NAC from 7 AA cases was not detected, and in one case initially diagnosed as chronic AA, one relapse case and two cases responding to therapy, a few CFU-GM were detected and maintained 2-4 weeks. It was considered that LTMC was useful to the analysis of pathogenesis and the guide to treatment of patients with AA.