In vitro tests for distinguishing possible immune-mediated aplastic anemia from transfusion-induced sensitization.
Forty-two patients with aplastic anemia (AA) were studied to determine whether or not transfusion-induced sensitization is responsible for the in vitro inhibition by patient lymphocytes of HLA-identical erythroid burst-forming units (BFU-E). The results indicate that lymphocytes from 12 of 34 transfused patients inhibited normal colony growth. In contrast, lymphocytes from none of the 8 untransfused patients demonstrated inhibition. These data were interpreted to mean that coculture studies would not be useful for identifying immune-mediated AA in transfused patients. Therefore, in order to identify possible immune-related AA, we assayed BFU-E from patient blood before and after T-cell depletion. In all 32 patients studied, BFU-E failed to grow from peripheral blood cells before T-cell depletion, but in 8 cases, normal-appearing BFU-E grew after T cells had been removed. Growth of patient BFU-E colonies was inhibited in 6 cases when patient T cells were added back to the culture, indicating that in these 6 patients, an "autoimmune" mechanism may have been present.
D000741:Anemia, Aplastic / Q000276:immunology*; D000818:Animals; D001803:Blood Transfusion; D002454:Cell Differentiation; D002478:Cells, Cultured; D004912:Erythrocytes / Q000166:cytology / Q000276:immunology; D006680:HLA Antigens; D006801:Humans; D007114:Immunization; D008214:Lymphocytes; D012397:Rosette Formation; D012756:Sheep
D006680:HLA Antigens