Leukemic blast cell colony formation in semisolid culture with
erythropoietin: a case report of acute poorly differentiated erythroid
leukemia
M Tomonaga, I Jinnai, M Tagawa, T Amenomori, K Nishino, E Yao, H Nonaka, K Kuriyama, Y Yoshida and T Matsuo
The bone marrow of a patient with acute undifferentiated leukemia developed
unique colonies after a 14-day culture in erythropoietin (EPO)-containing
methylcellulose. The colonies consisted of 20 to 200 nonhemoglobinized
large blast cells. Cytogenetic analysis of single colonies revealed
hypotetraploid karyotypes with several marker chromosomes that were
identical to those found in directly sampled bone marrow. The concurrently
formed erythroid bursts showed only normal karyotypes. No leukemic colony
formation was observed in other culture systems with either
colony-stimulating activity (CSA) or phytohemagglutinin-stimulated
leukocyte-conditioned medium (PHA-LCM). The leukemic colonies exhibited a
complete EPO-dose dependency similar to that of the patient's normal BFU-E.
Although cytochemical and immunologic marker studies of the bone marrow
cells failed to clarify the cell lineage of the leukemic cells with
extraordinarily large cell size, ultrastructural study revealed erythroid
differentiation such as siderosome formation in the cytoplasm and ferritin
particles in the rhophecytosis invaginations. These findings indicate that
the patient had poorly differentiated erythroid leukemia and that some of
the clonogenic cells might respond to EPO in vitro. Corresponding to this
biological feature, the leukemic cells were markedly decreased in number in
response to repeated RBC transfusions, and partial remission was obtained.
These observations suggest that erythroid leukemia distinct from
erythroleukemia (M6) with a myeloblastic component, can develop as a minor
entity of human acute leukemia.
Volume 69,
Issue 2,
pp. 546-552,
02/01/1987
Copyright © 1987 by The American Society of Hematology
