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Periodic oscillation of blood leukocytes, platelets, and reticulocytes in a
patient with chronic myelocytic leukemia
G Chikkappa, G Borner, H Burlington, AD Chanana, EP Cronkite, S Ohl, M Pavelec and JS Robertson
A patient with chronic myelocytic leukemia had a cyclic oscillation of
blood neutrophils, eosinophils, monocytes, platelets, normoblasts, and
reticulocytes but not of lymphocytes. The cycle interval was 53--69 days.
Except for reticulocytes all other cells cycled with neutrophils. Plasma
colony-stimulating factor (CSF) oscillated out of phase with neutrophils,
suggesting that granulocytopoiesis is regulated through CSF by a feed-back
mechanism. Plasma erythropoiesis-stimulating factor (ESF) also oscillated.
ESF crests preceded or coincided with reticulocyte crests, indicating that
the ESF elevation may have been responsible for the reticulocyte peaks. The
relationship between neutrophils and reticulocytes and their oscillations
with plasma CSF and ESF suggests that there is a common stem cell which
differentiates along one cell line or the other depending upon the balance
of regulatory stimuli. The fraction of blood neutrophilic precursors
(myeloblasts, promyelocytes, and myelocytes) in DNA synthesis fluctuated
with neutrophil level. The calculated generation time was shorter at the
crests than at the troughs of the neutrophil cycles. This finding suggested
that the rate of proliferation of the neutrophils changed periodically.
This observation, along with a periodic increase in differentiation of the
stem cell toward the neutrophilic cells, is the probable explanation of
oscillation of the neutrophil count in the blood.
Volume 47,
Issue 6,
pp. 1023-1030,
06/01/1976
Copyright © 1976 by The American Society of Hematology
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