SERIAL STUDY OF BONE MARROW IN HEMOLYTIC DISEASE OF THE NEWBORN (ERYTHROBLASTOSIS FETALIS)

PEDIATRICS ◽  
1959 ◽  
Vol 23 (2) ◽  
pp. 314-322
Author(s):  
Hugh C. Dillon ◽  
William Krivit
Keyword(s):  
Bone Marrow ◽  
Peripheral Blood ◽  
Exchange Transfusion ◽  
Rare Occurrence ◽  
Review Of The Literature ◽  
Hemolytic Disease ◽  
Cell Production ◽  
Cell Destruction ◽  
The Relationship ◽  
Marrow Activity

Fourteen infants with erythroblastosis fetalis were studied with particular reference to bone marrow activity and its relation to anemia in the infants. Serial studies of the marrow were done in 12 of the 14 infants, and single specimens were examined in two infants. No attempt is made to define the etiology or pathogenesis of the anemia of erythroblastosis fetalis. The purpose of this study was to determine the relationship between degree of anemia and normoblastic activity of bone marrow, as ascertained by morphologic techniques. On the basis of a review of the literature and the experience with this series of infants, true "aregenerative anemia" appears to be a rare occurrence. Indeed, to suggest that the anemia of erythroblastosis is commonly due to a cessation of erythropoiesis seems totally unjustified, because these infants show hyperplasia of the marrow which is analogous to that seen in other compensated hemolytic anemias. Human and Sturgeon have stated, and the authors agree, that a relative hypoplasia may occur as cell destruction exceeds cell production. This does not necessarily imply marrow failure or an "aregenerative state," but it may indicate that the balance can be in favor of blood destruction and an anemia of some degree is the result. In a previous report, infants after exchange transfusion did show excessive destruction of donor erythrocytes. The rate of destruction of Rh-negative cells in erythroblastosis fetalis was twice that of normal. Some of the cases reported in the literature as "aregenerative anemia" lack adequate marrow studies and cannot be accepted as well-documented. It should be emphasized that it may be unwise to conjecture about activity of the bone marrow from reticulocyte studies of the peripheral blood alone. In this series, the percentage of normoblats in the bone marrow was increased in proportion to the degree of anemia.

scholarly journals The Outcome of Hemolytic Disease of the Fetus and Newborn Caused by Anti-Rh17 Antibody: Analysis of Three Cases and Review of the Literature

2019 ◽  
Vol 47 (3) ◽  
pp. 264-271 ◽  
Author(s):  
Slavica Dajak ◽  
Nina Ipavec ◽  
Mia Cuk ◽  
Branka Golubic Cepulic ◽  
Jela Mratinovic-Mikulandra ◽  
...  
Keyword(s):  
High Frequency ◽  
Exchange Transfusion ◽  
Perinatal Death ◽  
Good Health ◽  
Published Data ◽  
Review Of The Literature ◽  
Hemolytic Disease ◽  
Tertiary Institution ◽  
Intrauterine Transfusion ◽  
Different Populations

Background: Anti-Rh17 is a rare red blood cell (RBC) antibody to high-frequency antigens that may cause severe hemolytic disease of the fetus and newborn (HDFN). Despite the rarity of HDFN caused by Anti-Rh17, this antibody was reported in many different populations. Emergency transfusions, especially exchange transfusions, present a huge problem if no compatible RBCs of phenotype D-- are available. Methods: Here we report obstetrical histories of three women and describe their pregnancies complicated by anti-Rh17 antibodies. We summarized published cases of pregnancies complicated by anti-Rh17 and reviewed transfusion treatment and outcomes. Additionally, a simplified flowchart for the management of such pregnancies is proposed. Results: Four pregnancies were affected by severe HDFN, and three of them ended with perinatal death. In the fourth case, the baby was born hydropic and icteric and the condition was rapidly deteriorating. Emergency exchange transfusion was performed with incompatible O-negative RBC units in AB-negative plasma. The baby was discharged on the 14th day in good health. In the available literature, 15 women and 22 pregnancies were reported, 20 of them developed severe HDFN. According to the data, intrauterine transfusion for treatment of HDFN was the most common form of treatment with the donation of the mother’s blood. Different options for exchange transfusion were described, including incompatible RBCs. Conclusion: In more than 90% of described pregnancies of HDFN caused by anti-Rh17 antibody, transfusion treatment was required. Therefore, RBC from D-- phenotype has to be available. According to published data, in emergent circumstances when maternal and blood from donor with phenotype D-- is not available, incompatible exchange transfusion is a better choice than delaying transfusion when it is necessary. It is of essential importance that pregnancies with high risk of HDFN due to anti-Rh17 are managed by a multidisciplinary team (transfusion medicine specialist, obstetrician, neonatologist) in a highly specialized tertiary institution.

scholarly journals Disseminated Gastric MALT Lymphoma with Monoclonal Gammopathy, t(11;18)(q21;q21), and Subsequent Development of T-Large Granular Lymphocytic Leukemia: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Riad Akoum ◽  
Wassim Serhal ◽  
Hussein Farhat
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Malt Lymphoma ◽  
Peripheral Blood ◽  
Marginal Zone ◽  
Granular Cell ◽  
Gastric Malt Lymphoma ◽  
Review Of The Literature ◽  
Malt Type Lymphoma ◽  
Hodgkin's Lymphomas

Background. Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) is a well-characterized entity that may share clinical and morphological findings with other low-grade non-Hodgkin’s lymphomas. Dissemination of MALT-type lymphoma to bone marrow and peripheral blood simultaneously with the presence of T-large granular cell leukemia (T-LGL) has rarely been reported.Case Presentation. This is the case of a 42-year-old male who presented with a gastric MALT-type lymphoma, disseminated to the bone marrow and the peripheral blood with high serum IgM levels and t(11;18)(q21;q21). The morphological, immunophenotypical and, immunohistochemical studies of the successive bone marrow and peripheral blood samples had revealed the coexistence of two distinct lymphoma cell populations: a B-cell, marginal zone type population expressing CD19, CD20, CD22, CD79b, IgM, and kappa light chain, and a T-large granular cell population, developed after treatment with rituximab expressing CD3, CD8, CD5, CD7, and CD45.Conclusion. Based on the analysis of this unusual case we performed an extensive review of the literature to elucidate the relationship between T-LGL and B-cell lymphomas and to emphasize the importance of paraprotein analysis at diagnosis of gastric MALT lymphoma.

Genetic influences upon eosinophilia and resistance in mice infected with Trichinella spiralis

Parasitology ◽  
1992 ◽  
Vol 105 (1) ◽  
pp. 117-124 ◽  
Author(s):  
D. A. Lammas ◽  
D. Wakelin ◽  
L. A. Mitchell ◽  
M. Tuohy ◽  
K. J. Else ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Peripheral Blood ◽  
Post Infection ◽  
Trichinella Spiralis ◽  
Secondary Infection ◽  
Genetic Influences ◽  
F1 Hybrids ◽  
Cell Populations ◽  
Response Phenotype ◽  
The Relationship

Genetic influences upon host variation in eosinophilia and resistance to helminth infection, and the relationship between these parameters, were investigated in 7 inbred and 1 hybrid strains of mice infected with Trichinella spiralis. Clear strain-dependent variations were observed in the maximum peripheral blood, bone marrow and spleen eosinophilia attained in infected animals. SWR, NIH and SJL strains of mice all gave high responses to infection; four congenic strains sharing the B10 background (C57BL10 [B10], B10.S, B10.G and B10.BR) were low responders. Some of the genes for high responsiveness appeared to be dominant, as F1 hybrids from high- and low-response phenotype parental strains showed intermediate to high responses to infection. Intestinal eosinophilia showed no correlation with either peripheral blood or bone marrow responses (NIH and B10 strains having similar levels of eosinophil response in gut tissue) and was unrelated to the level of resistance to infection. Whereas NIH were highly resistant, with adult worm burdens at 13 days post-infection and muscle larval burdens at 35 days post-infection significantly lower than all other strains, B10 were quite susceptible, retaining substantial worm burdens at day 13 and harbouring large numbers of muscle larvae. Measurements of the level of the eosinophilopoietic cytokine IL-5 in sera during infection showed that the two strains differed in the kinetics of release but not in their absolute capacity to produce this cytokine. NIH mice released high levels during a primary infection, B10 released high levels during a secondary infection. The relationship between eosinophilia and resistance and the differences seen between responses in different body compartments are discussed in terms of genetically determined influences operating at the levels of T helper cell populations, T cell cytokines and bone-marrow precursor cell populations.

scholarly journals PHOX2B expression in bone marrow and peripheral blood is associated with metastasis and prognosis in patients with neuroblastoma

2020 ◽  
Author(s):  
Hongjun Fan ◽  
Tianyu Xing ◽  
Huimin Hong ◽  
Chao Duan ◽  
Wen Zhao ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Peripheral Blood ◽  
Clinical Characteristics ◽  
Operating Characteristic ◽  
Neuroblastoma Cells ◽  
Prognostic Analysis ◽  
Kaplan Meier ◽  
Polymerase Chain ◽  
The Relationship

Abstract Background Paired-like homeobox 2B (PHOX2B) is specifically expressed in the nervous system including neuroblastoma cells, but little is known about the clinical significance of the expression of PHOX2B in bone marrow (BM) and peripheral blood (PB) samples of newly diagnosed neuroblastoma patients. Methods The expression of PHOX2B in 276 paired BM and PB samples of neuroblastoma patients at diagnosis was tested by quantitative reverse transcriptase polymerase chain reaction (RT-PCR). Then the relationship between PHOX2B level and clinical characteristics including metastasis and prognosis was explored by receiver operating characteristic (ROC) analysis and Kaplan-Meier method. Results We identified the combined expression of PHOX2B in both BM and PB provided a high diagnostic accuracy for metastasis of neuroblastoma patients (AUC = 0.920) with the sensitivity and specificity of 86.7% and 92.9%, respectively. At last, 246 patients were enrolled for prognostic analysis. The median follow-up time was 22 months. Positive expressions of PHOX2B in BM and PB at diagnosis were associated with worse EFS and OS in neuroblastoma patients (P < 0.05). What’s worse, 19.7% (31/157) and 6.4% (10/157) patients with positive expression of PHOX2B in BM and PB samples in low/intermediate-risk group also had shorter EFS and poor OS (P < 0.05). CONCLUSIONS The expressions of PHOX2B in BM and PB were high in patients with unfavorable clinical characteristics. PHOX2B could be an appropriate biomarker for predicting metastasis and prognosis in patients with neuroblastoma.

DAMAGE OF THE BONE MARROW DUE TO RH ANTIBODY

PEDIATRICS ◽  
1956 ◽  
Vol 17 (1) ◽  
pp. 37-44
Author(s):  
Eloise R. Giblett ◽  
Jorge E. Varela ◽  
Clement A. Finch
Keyword(s):  
Bone Marrow ◽  
Antibody Titer ◽  
Exchange Transfusion ◽  
High Titer ◽  
Hemolytic Disease

Detailed hematologic studies were carried out in an infant with hemolytic disease of the newborn following exchange transfusion who manifested a high titer of anti-D antibody in the serum and evidence of impaired erythropoiesis. The relation between falling antibody titer and resumption of erythrocyte production supports the hypothesis that the antibody may act against erythrocyte precursors. The various stages of involvement of the erythron by antibodies are discussed.

The Effect of Rhg-CSF on MDSC In Bone Marrow and Peripheral Blood Cells

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4709-4709
Author(s):  
Yiwen Ling ◽  
Qifa Liu ◽  
Zhiping Fan ◽  
Xiuli Wu ◽  
Can Liu ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Peripheral Blood ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Hematopoietic Stem ◽  
Healthy Donors ◽  
The Difference ◽  
The Relationship ◽  
Stimulating Factor

Abstract Abstract 4709 Objective: As granulocyte colony-stimulating factor, recombinant human granulocyte colony stimulating factor (rhG-CSF) is widely used in neutropenic patients. In addition to stimulating the growth of granulocyte, rhG-CSF can promote hematopoietic stem cells from bone marrow (BM) to peripheral blood (PB) and has the effect of immune regulation. Myeloid-derived suppressor cells (MDSC) are a group of heterogeneous cells, derived from bone marrow progenitor cells and immature myeloid cells. Recently, MDSC is researched in the field of solid tumor, but not in the field of hematopoietic stem cell transplantation. Here, we investigate rhG-CSF's effect on MDSC in healthy donors’ BM, PB and the relationship between MDSC and graft-verse-host disease (GVHD). Methods: We obtained the BM and PB samples before mobilization and the BM APB and peripheral blood stem cell collection (PBSC) on the 5th day after the rhG-CSF mobilization from 12 healthy donors, respectively. Then we used the flow cytometry to check the absolute number of MDSC. Finally, we analyzed the relationship between the number of MDSC and the incidence of GVHD. Results: In normal physiological conditions, the MDSC could be detected in healthy donor's PB and BM. In PB, the proportion of MDSC in the mononuclear cells was 1.35 ± 0.35%. In BM, the proportion was 2.44 ± 1.11%. The proportion in BM is higher than that in PB, the difference was statistically significant (P=0.047). On the 5th day after the rhG-CSF mobilization, the MDSC ratio of mononuclear cell in PB were 4.01 ± 1.82%. In BM, the ratio was 4.38 ± 2.19%. The difference between the ratio of MDSC in BM and PB was no significant (P=0.076). The number of mobilized peripheral blood MDSC was significantly higher than that before mobilization (P=0.015), while the difference between the numbers of bone marrow MDSC cells before and after mobilization was not significant (P=0.083). The numbers of MDSC in collection and the incidence of GVHD had a significant negative correlation (P=0.048). Conclusion: MDSC could be detected in the healthy donors’ PB and BM, the numbers of MDSC in BM were higher than that in PB. The rhG-CSF could mobilize more MDSC from BM to the peripheral blood, and the increased s of MDSC in PB after rhG-CSF mobilization might be related to the low incidence of GVHD in hematopoietic stem cell transplantation. Supported by National Natural Science Foundation of China (30971300), Science and Technology Planning Project of Guangdong Province of China (2009A030200007) and China Postdoctoral Science Foundation (200902332, 20080440776). Disclosures: No relevant conflicts of interest to declare.

scholarly journals Brief Report: Erythropoiesis after Exchange Transfusion in Hemolytic Anemia

Blood ◽  
1966 ◽  
Vol 27 (2) ◽  
pp. 242-246 ◽  
Author(s):  
ALLAN J. ERSLEV ◽  
JOSEPH P. MCKENNA
Keyword(s):  
Bone Marrow ◽  
Hemolytic Anemia ◽  
Exchange Transfusion ◽  
Serum Iron ◽  
Hereditary Spherocytosis ◽  
Hemoglobin Concentration ◽  
Tissue Hypoxia ◽  
Red Cell ◽  
Cell Production ◽  
Significant Change

Abstract Exchange transfusion with preservation of a constant hemoglobin concentration in three patients with hereditary spherocytosis, and one patient with acquired hemolytic anemia did not result in any significant change in the rate of red cell production as measured by serum iron turnover and bone marrow examinations. These observations support the hypothesis that tissue hypoxia controls red cell production.

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