Peripheral Blood and Bone Marrow Abnormalities in the Acquired Immunodeficiency Syndrome

In reviewing the peripheral hematologic manifestations, bone marrow changes and clinical course in 41 consecutive patients with acquired immunodeficiency syndrome (AIDS), frequent findings included anemia (95%), leukopenia (76%), bone marrow hypercellularity (73%) and pancytopenia (41%). These hematologic abnormalities were not clearly associated with specific clinical manifestations of AIDS, but support the conclusion that the hematopoietic system is a target organ in AIDS. The mechanisms of these abnormalities still need to be evaluated. Clinicians should be aware of these commonly encountered changes.     

Circadian Variations in Human Peripheral Blood on Days With and Without Bone Marrow Sampling and Relation to Bone Marrow Cell Proliferation

Fifteen bone marrow (BM) and venous blood circadian profiles were obtained from 13 diurnally-active, healthy men sampled every 4-5 h for 24 h. Peripheral blood (PB) was also sampled in subsets of 5 men either for 24 h immediately preceding the BM procedure or 5-6 months afterwards. Cortisol and white and red cell parameters were determined in PB. BM cell cycle distribution was investigated in parallel by flow cytometry for S-phase DNA of total mononuclear cells and subpopulations of erythroid and myeloid precursor cells. On a group basis, significant circadian rhythms were found in PB variables commonly referred to as "marker" rhythms (cortisol, total white cells [WBC], neutrophils [N], lymphocytes [L]), with acrophases less than 2 h apart between the contro l day prior to and during BM sampling. Thus, major, but relatively short-lasting physiological stress, like BM aspirations or blood sampling itself, although repeated several times over 24 h, seemed to have minor influence on these rhythms on days of the BM procedure. When comparing the times of highest or lowest values in PB with times of highest or lowest values in BM, several temporal relationships were found. Among other associations, timing of lowest values in WBC, N and L or highest values in cortisol was significantly predictive of highest values in myeloid cells occurring in the following 12 h, whereas highest values in erythroid cells occurred significantly more often in the 12 h interval beginning 4 h after the time of lowest values in WBC, L and N. The stability in the circadian rhythms of the PB variables suggests that information obtained on one day can be used to guide procedures on the next, such as BM myelotoxic chronotherapy or BM harvesting.     

New Stains for Blood and Bone Marrow Cells

Traditionally, blood and bone marrow cells have been identified based on their characteristic shapes and colors when stained with one of several panoptic stains including Wright's or Giemsa's. As questions arose regarding the origin of normal and leukemic cells, cytochemical stains were developed. These stains help identify cells on the basis of a distinctive metabolite or enzyme. As part of an ongoing tradition in which textile dyes are used for biological staining, several new stains have been applied to hematologic staining. These include C.I. basic blue 41, basic blue 141, basic blue 93, and an assymetrical polymethine dye. As additional cell-selective stains are developed, we can anticipate further improvements in our ability to identify normal and malignant hematopoietic cells.     

骨髓单个核细胞抗体及外周血B淋巴细胞与IRP的相关性研究

采用流式细胞术双标法检测拟诊免疫相关性全血细胞减少症患者(A组)、非免疫相关性恶性血液病患者(B组)及正常人(正常对照组)的骨髓单个核细胞结合的自身抗体,同时检测B组、确诊免疫相关性全血细胞减少症(C组)及正常对照组外周血B淋巴细胞及CD5+B淋巴细胞比率;A组中16例骨髓造血细胞自身抗体阳性,阳性率88.88%;B组1例骨髓造血细胞自身抗体阳性,阳性率9.09%。C组外周血B淋巴细胞、CD5+B淋巴细胞比率显著高于B组及正常对照组(P均<0.05),而正常对照组外周血B淋巴细胞、CD5+B淋巴细胞显著高于B组(P均<0.05);IRP患者骨髓单个核细胞自身抗体表达显著增高,B淋巴细胞总数及CD5+B淋巴细胞数量显著增高可能是IRP发病的重要因素之一;利用流式细胞术检测骨髓造血细胞自身抗体及B淋巴细胞数可以为IRP提供科学可靠的依据,优于骨髓Coomb’s实验。     

Rate and Time of Dna Synthesis of Human Leukaemic Blasts In Bone Marrow and Peripheral Blood

Abstract. We have evaluated DNA synthesis rate (S rate) and time (T_s) and tritiated thymidine labelling index (LI) of peripheral blood (PB) and/or bone marrow (BM) leukaemic blasts (Bl) in nineteen cases of acute leukaemia (twelve non-lymphoblastic, AnLL, and seven lymphoblastic, ALL), in one case of non-Hodgkin's leukaemic lymphoma and in a case of plasma cell leukaemia.
The LI of PB-BI was significantly lower than that of BM-Bl (range 0.1-6.2% and 1.9-19.5%, respectively; P < 0.01). the S rate was higher for PB-Bl than for BM-Bl (range 3.5-11-3 and 2.5-9.5 mol × 10-¹⁸/min; P < 0.02) and the T^s of PB-Bl was shorter than that of BM-Bl (range 7.6-22.1 and 10.8-34.7 hr, respectively; P < 0.02). In eight cases where S rates of both BM-Bl and PB-Bl were available, a linear correlation ( r = 0.82; P < 0.01) was found between the two parameters. This suggests that the DNA synthetic rate is a property of the leukaemic cell line in individual patients and differs from case to case. It further indicates that the environmental influences on the DNA synthesis rate in BM or PB are always of the same order of magnitude. From the results of this study we speculate that the DNA synthesis rate of leukaemic blasts is slowed down in the BM by environmental factors such as cell density.     

The Effect of Decalcification and Choice of Fixative on Histiocytic Iron in Bone Marrow Core Biopsies

Iron stains are often used for bone marrow core biopsies obtained by needle biopsy of the iliac crest. Because bone most be decalcified by brief treatment with acid, it is possible that an undetermined amount of stainable histiocytic iron may be lost. A study was carried out to determine whether decalcification results in loss of histiocytic iron and the effects of fixatives and the recovery of histiocytic iron in decalcified bone marrow tissue. Aspirates of bone marrow were stained for iron with Prussian blue. Because aspirate material does not require decalcification, it served as a control for the study. One hundred bone marrow biopsies and accompanying aspirates from 100 adult subjects were evaluated. Fifty bone marrow biopsies were fixed using a fixative containing mercuric chloride (B-5) and the remaining 50 were fixed in zinc-formalin. Histiocytic iron was graded as minimal, moderate or marked depending on whether less than 5, 6-10, or more than 10 iron positive histiocytes, respectively, were observed. When histiocytic iron was markedly present in aspirate material, at least moderate amounts of stainable iron were found in 22 of 25 B-5 fixed and 21 of 25 zinc-formalin fixed decalcified bone marrow. When aspirate histiocytic iron was minimal or moderate, 14 of 25 B-5 fixed and 7 of 25 zinc-formalin fixed decalcified bone marrow specimens revealed histiocytic iron. Decalcification results in decreased recovery of stainable iron, and where histiocytic iron is minimally or moderately present, B-5 fixation results in greater postdecalcification recovery. There was no significant difference in recovery when larger quantities of histiocytic iron were present prior to the decalcification step.     

小鼠骨髓造血干细胞、外周血组成随年龄的变化趋势及其相关性分析

造血干细胞是具有自我更新能力并能分化为血液中各种血细胞组分的多能干细胞。近来研究显示,不同造血干细胞表面标志物标记的造血干细胞具有分化为不同血细胞的趋势,但是这种分化的内在关系仍不清楚。对小鼠CD34~-/Sca-1~+骨髓造血干细胞、外周血组成随小鼠年龄增长的变化情况进行了分析,结果显示:随着年龄的增长,骨髓中的CD34~-/Sca-1~+骨髓造血干细胞比率显著增加;而外周血各组分则随年龄变化呈现不同的趋势。对不同年龄段小鼠的骨髓造血干细胞及其他组分与外周血组分的同步分析发现,外周血中血小板密度变化趋势与CD34~-/Sca-1~+骨髓造血干细胞变化情况相关系数为0.804 8;外周血中淋巴细胞密度变化趋势与CD34~+/Sca-1~-骨髓细胞的变化情况相关系数为0.947 97;外周血中白细胞密度变化趋势与CD34~+/Sca-1~+骨髓细胞变化情况相关系数为0.763 1(大于0.9为极度相关,0.7到0.9为高度相关)。     

Leakage of Oxygen from Blood and Water Samples Stored in Plastic and Glass Syringes

Theory and experiment showed that samples of blood and water stored in 2-ml and 5-ml syringes made of polypropylene, polystyrene, or S.A.N. co-polymer exchanged oxygen with their surroundings. In the first hour the exchange was due mainly to equilibration with the plastic of the syringe and only in small degree to permeation through the plastic. With high initial tension or with blood of low haemoglobin concentration the exchange can result in errors in Po₂ of up to 6% in two minutes and 16% in 30 to 60 minutes. With all-glass syringes the exchange was much slower but, even so, after 24 hours was important in all but a few of 18 interchangeable glass syringes. Therefore unless analysis can be started immediately all-glass syringes are to be preferred, and for prolonged storage even these should be selected.     

Cytogenetic Effects of Cyclohexylamine and N-OH-Cyclohexylamine on Human Leucocytes and Chinese Hamster Bone Marrow

SOME humans metabolize the commonly used artificial sweetener, cyclamate, to cyclohexylamine (CHA) and N-hydroxycyclo-hexylamine (N-OHCHA). There have been three reports^1–3 that cyclamate and its metabolic byproducts cause a significant amount of cytogenetic damage in cultured human cells and the bone marrow and spermatogonial cells of the rat, but unfortunately they do not give quantitative cytogenetic data, other than the percentages of cells with “breaks”. In our experiments, we attempted to detect significant cytogenetic damage to human leucocytes treated in vitro or in a host-mediated assay system with CHA or N-OHCHA. At the same time, bone marrow from Chinese hamsters was studied for cytogenetic effects after daily injections of CHA.     

Blood and Bone Marrow Studies in Cattle Feeding on Brassica Species

Daily administration of 40—60 kg rape for 9 weeks to 8 cows produced no changes in the red blood picture. On the other hand a reduction of the myeloid: erythroid ratio and the maturity ratio of the erythroid cells of the bone marrow was found. This is interpreted as a sign of increased erythropoiesis. The Brassica-induced anaemia found in other investigations is assumed on several grounds to be haemolytic. The present study confirms this assumption, the increased breakdown of erythrocytes being entirely compensated by an increased erythropoiesis. The difference between the present and earlier reports, in which anaemia was found after a shorter time of feeding on roughly the same quantities of rape, is discussed, one possible explanation being that differences exist in rhodanid content between Brassica species.     

Cytometry and Time-Dependent Variations in Peripheral Blood and Bone Marrow Cells: A Literature Review and Relevance to the Chronotherapy of Cancer

By flow cytometry of individual cells, multiple cell properties can be analyzed. Such parameters may be important in relation to cytotoxic treatment of cancer. For example, DNA measurements will answer questions regarding cell kinetics. Myelosuppression is the major dose-limiting toxicity during cancer treatment. Therefore, the study of cell cycle parameters in bone marrow cells is highly relevant. However, inattention to the existence and potential importance of biological rhythms may introduce artifacts and misleading results. The literature of rhythms in hematology is reviewed. Time-dependent variations in hematological variables have been extensively studied and rhythms have been described for all kinds of blood cells. Also the numbers of hemopoietic stem cells in the bone marrow undergo circadian variations. Our group has shown how such variations change with aging in mice. The relevance of time sequence studies in aging research of hemopoiesis was clearly demonstrated. In animal studies using cytometry, our group has demonstrated extensive circadian variations in cell cycle distribution of bone marrow cells, especially the DNA synthesis (S-phase). In humans a few and rather small time sequence studies of the bone marrow have been performed, so far. In this overview the clinical implications of circadian rhythms of S-phase variations measured by flow cytometry of human bone marrow cells are discussed. Male volunteers were examined every 4 h around-the-clock. The data indicated a lower proliferative activity during night, suggesting the possibility of reducing the bone marrow toxicity to cancer treatment when taking these time-dependent variations into consideration.     

影响骨髓移植术后环孢素A血药浓度的相关因素分析

目的:环孢素A是临床常用的免疫抑制剂,应用于预防骨髓移植术后发生的移植物抗宿主病。环孢素A药代动力学及药效学个体差异大,治疗窗窄,其血药浓度受多种因素影响。本文研究探讨骨髓移植术后患者环孢素A血药浓度,寻找影响其血药浓度变化的可能因素,并为临床上药物使用提供参考依据。方法:以化学发光微粒子免疫分析法测定并记录骨髓移植术后患者应用环孢素A后的血药浓度,并根据环孢素A血药浓度、患者的基本情况(性别、年龄、手术日期等)、用药情况(剂量、给药方式、合并用药等)及相应生化检验结果等,应用SPSS统计软件对数据进行多元线性回归分析,考察环孢素A血药浓度与各生化指标的相关性。结果:环孢素A的单位血药浓度与患者的性别、年龄及体重无明显的相关性,与血浆CHO、AST、BUN、三唑类抗真菌药物具有统计学意义的相关性(P0.05)。结论:环孢素A的血药浓度不仅受自身个体因素的影响,还与给药方式、合用药物情况等外界因素有关。应结合患者的临床表现进行全面分析,建议定期监测血药浓度,及时调整治疗方案,实现个体化给药,使环孢素A在骨髓移植术后的应用得到最佳的治疗效果。     

流行性出血热病毒对健康人外周淋巴细胞和大白鼠骨髓细胞染色体影响的研究

用流行性出血热病毒(EHFV)A9株,滴度为TCID_(50)10~(-5)/0.1ml,加入10名健康人外周血,作淋巴细胞姊妹染色单体互换(SCE)和染色体畸变的检测。每份血分对照组(不加病毒悬液)和A、B、C实验组(根据加不同病毒量而分)。其结果:一、SCE频率,实验组A(8.9±0.19)、实验组B(9.9±0.2)、实验组C(11.6±0.22)与对照组(6.57±0.15)比较,A、B、C、实验组均分别高于对照组,P<0.01,差异有高度显著性,A、B、C三个实验组比较,P<0.01,差异有高度显著性。二、染色体畸变,A、B、C三个实验组分别与对照组比较,P>0.05,差异均无显著性。用EHFV HA 108株,ID_(50)10~(-6)/0.02ml接种2—5日龄大白鼠脑内,15天后颈动脉放血处死,取骨髓细胞培养,另取幼大白鼠骨髓细胞培养作对照,检测SCE和染色体畸变。结果:一、SCE频率,实验组(9.8±0.35)高于对照组(5.4±0.19),P<0.01,差异有高度显著性。二、染色体畸变,实验组与对照组比较,P>0.05,差异无显著性。以上两个实验结果表明,EHFV作用于细胞,无论是在机体或试管内,都引起SCE频率增高,即EHFV促使DNA产生初级损伤,但不致染色体畸变。     

Comparison of Trypanosome Incidence in Blood and Bone Marrow from 79 Colorado Birds

Seventy-nine adult birds in 8 species were examined at autopsy for the presence of Trypansoma avium. Films of thoracic blood were stained in Giemsa and later searched for trypanosomes. Marrow was removed from femora and humeri, mixed with Ringer's solution, and examined direct for living flagellates. Sixty-four birds (81%) showed positive marrows; 5 (6%) had positive bloods. In the 15 birds with negative marrows, only 2 had trypanosomes in the blood. These data emphasize the advantage of marrow over blood examination in determining the incidence of avian trypanosomiasis and point up the excellence of fresh marrow examination in such studies.     

Reproducibility of Circulating MicroRNAs in Stored Plasma Samples

Background

Most studies of microRNA (miRNA) and disease have examined tissue-specific expression in limited numbers of samples. The presence of circulating miRNAs in plasma samples provides the opportunity to examine prospective associations between miRNA expression and disease in initially healthy individuals. However, little data exist on the reproducibility of miRNAs in stored plasma.

Methods

We used Real-Time PCR to measure 61 pre-selected microRNA candidates in stored plasma. Coefficients of variation (CVs) were used to assess inter-assay reliability (n = 15) and within-person stability over one year (n = 80). Intraclass correlation coefficients (ICCs) and polychoric correlation coefficients were used to assess within-person stability and delayed processing reproducibility (whole blood stored at 4°C for 0, 24 and 48 hours; n = 12 samples).

Results

Of 61 selected miRNAs, 23 were detected in at least 50% of samples and had average CVs below 20% for inter-assay reproducibility and 31 for delayed processing reproducibility. Ten miRNAs were detected in at least 50% of samples, had average CVs below 20% and had ICCs above 0.4 for within-person stability over 1–2 years, six of which satisfied criteria for both interassay reproducibility and short-term within-person stability (miR-17-5p, -191-5p, -26a-5p, -27b-3p, -320a, and -375) and two all three types of reproducibility (miR-27b-3p and -26a-5p). However, many miRNAs with acceptable average CVs had high maximum CVs, most had low expression levels, and several had low ICCs with delayed processing.

Conclusions

About a tenth of miRNAs plausibly related to chronic disease were reliably detected in stored samples of healthy adults.     

MicroRNA Signatures in Blood or Bone Marrow Distinguish Subtypes of Pediatric Acute Lymphoblastic Leukemia

OncomiRs are microRNAs that are associated with early onset of specific cancers. To identify microRNAs involved in pediatric acute lymphoblastic leukemia (ALL) subtypes T-ALL and B-ALL, peripheral blood and bone marrow samples were independently subjected to microarray analysis using two different high-fidelity array platforms. The unique and common gene signatures from both arrays were validated by TaqMan individual assays in 100 pediatric ALL samples. Survival studies were carried out in the test set and validation set with 50 randomly selected samples in each set. MicroRNA expression profile revealed characteristic signatures for distinguishing T and B lineages and identified 51 novel microRNAs in pediatric ALL. Interestingly, the present study also revealed endogenous similarities and differences between blood and bone marrow within each ALL subtype. When Cox regression analysis was carried out with these identified microRNAs, 11 of them exhibited expression levels significantly correlated with survival. Validation of some of the common and relevant microRNAs from both arrays showed that their targets are involved in key oncogenic signaling pathways. Thus, this study suggests that microRNAs have the potential to become important diagnostic tools for identification and monitoring clinical outcomes in ALL patients.