FLOW CYTOMETRY ANALYSIS OF BONE MARROW HEMATOPOIESIS IN PATIENTS WITH IMMUNE THROMBOCYTOPENIA (ITP)
(Abstract release date: 05/21/15)
EHA Library. Shubinsky G. 06/12/15; 102964; PB1957
Disclosure(s): Soroka University Medical Center, Ben-Gurion University of the NegevFlow Cytometry Unit, Hematology Laboratory and Institute of Hematology
George Shubinsky
Contributions
Contributions
Abstract
Abstract: PB1957
Type: Publication Only
Background
Immune thrombocytopenia (ITP) is a clinically and pathogenetically diverse autoimmune disorder resulted from antibody and/or T-cell mediated destruction of platelets and insufficient platelet production by immunologically affected megakaryocytes. The studies of bone marrow (BM) hematopoiesis in ITP show morphologically normal marrow with increased number of megakaryocytes in many patients. Abnormal levels of plasma thrombopoietin, interleukin 6 and some other hematopoietic cytokines were recently reported in patients with ITP, and these suggested a disorder of cytokine regulation with possible consequences for BM hematopoiesis. BM examination is usually unnecessary for patients with ITP, but flow cytometry (FC) study of BM is needed in some thrombocytopenic patients to exclude non-immune causes of cytopenia. The data of multi-parametric FC analysis in these patients represent a good opportunity to determine morphologically undetectable abnormalities in BM hematopoiesis at ITP.
Aims
The aim of current study was to examine hematopoiesis in patients with ITP by FC analysis of their BM.
Methods
FC records of eleven adult and seven pediatric patients with non-treated primary ITP from our database were enrolled for retrospective analysis. Different types of hematopoietic progenitor cells, B-lineage, myeloid and nucleated erythroid cells of different maturity were counted in BM of patients with ITP using several eight-color staining protocols and multi-parametric FC analysis. The data from ITP patients were compared with the data from hematologically normal adult (n=29) and pediatric (n=7) BM.
Results
Differential count of BM cells by FC detected the elevated numbers of total CD34+ hematopoietic progenitors, CD34+/cytoCD79a+/nuTdT+ B-lineage progenitors, CD34+/CD33+ committed myeloid progenitors and probable increase of early erythroid progenitors (erythroblasts) in adult patients with ITP when compared with normal adult BM and BM from patients with idiopathic cytopenia of undetermined significance as pathological control. FC showed an increased fraction of CD10+/CD20+/nuTdT- immature B cells and increase of total population of B cells in BM of adult patients with ITP. In contrast to adult patients, a reduced number of B cells was found in BM of pediatric patients with ITP, and it resulted from decrease of B-cell progenitors and immature B cells. FC revealed no other significant differences between BM of pediatric patients with ITP and age-related controls.
Summary
The present data suggest an acceleration of hematopoiesis in adult patients with ITP and address the question of its potential role in the pathogenesis of disease. Opposite changes in the composition of BM B cells in adults and children may reflect a different pathogenetic role of B cells and BM lymphopoiesis in the adult and pediatric ITP.
Keyword(s): Bone Marrow, Flow cytometry, Hematopoiesis, Immune thrombocytopenia (ITP)
Type: Publication Only
Background
Immune thrombocytopenia (ITP) is a clinically and pathogenetically diverse autoimmune disorder resulted from antibody and/or T-cell mediated destruction of platelets and insufficient platelet production by immunologically affected megakaryocytes. The studies of bone marrow (BM) hematopoiesis in ITP show morphologically normal marrow with increased number of megakaryocytes in many patients. Abnormal levels of plasma thrombopoietin, interleukin 6 and some other hematopoietic cytokines were recently reported in patients with ITP, and these suggested a disorder of cytokine regulation with possible consequences for BM hematopoiesis. BM examination is usually unnecessary for patients with ITP, but flow cytometry (FC) study of BM is needed in some thrombocytopenic patients to exclude non-immune causes of cytopenia. The data of multi-parametric FC analysis in these patients represent a good opportunity to determine morphologically undetectable abnormalities in BM hematopoiesis at ITP.
Aims
The aim of current study was to examine hematopoiesis in patients with ITP by FC analysis of their BM.
Methods
FC records of eleven adult and seven pediatric patients with non-treated primary ITP from our database were enrolled for retrospective analysis. Different types of hematopoietic progenitor cells, B-lineage, myeloid and nucleated erythroid cells of different maturity were counted in BM of patients with ITP using several eight-color staining protocols and multi-parametric FC analysis. The data from ITP patients were compared with the data from hematologically normal adult (n=29) and pediatric (n=7) BM.
Results
Differential count of BM cells by FC detected the elevated numbers of total CD34+ hematopoietic progenitors, CD34+/cytoCD79a+/nuTdT+ B-lineage progenitors, CD34+/CD33+ committed myeloid progenitors and probable increase of early erythroid progenitors (erythroblasts) in adult patients with ITP when compared with normal adult BM and BM from patients with idiopathic cytopenia of undetermined significance as pathological control. FC showed an increased fraction of CD10+/CD20+/nuTdT- immature B cells and increase of total population of B cells in BM of adult patients with ITP. In contrast to adult patients, a reduced number of B cells was found in BM of pediatric patients with ITP, and it resulted from decrease of B-cell progenitors and immature B cells. FC revealed no other significant differences between BM of pediatric patients with ITP and age-related controls.
Summary
The present data suggest an acceleration of hematopoiesis in adult patients with ITP and address the question of its potential role in the pathogenesis of disease. Opposite changes in the composition of BM B cells in adults and children may reflect a different pathogenetic role of B cells and BM lymphopoiesis in the adult and pediatric ITP.
Keyword(s): Bone Marrow, Flow cytometry, Hematopoiesis, Immune thrombocytopenia (ITP)
Abstract: PB1957
Type: Publication Only
Background
Immune thrombocytopenia (ITP) is a clinically and pathogenetically diverse autoimmune disorder resulted from antibody and/or T-cell mediated destruction of platelets and insufficient platelet production by immunologically affected megakaryocytes. The studies of bone marrow (BM) hematopoiesis in ITP show morphologically normal marrow with increased number of megakaryocytes in many patients. Abnormal levels of plasma thrombopoietin, interleukin 6 and some other hematopoietic cytokines were recently reported in patients with ITP, and these suggested a disorder of cytokine regulation with possible consequences for BM hematopoiesis. BM examination is usually unnecessary for patients with ITP, but flow cytometry (FC) study of BM is needed in some thrombocytopenic patients to exclude non-immune causes of cytopenia. The data of multi-parametric FC analysis in these patients represent a good opportunity to determine morphologically undetectable abnormalities in BM hematopoiesis at ITP.
Aims
The aim of current study was to examine hematopoiesis in patients with ITP by FC analysis of their BM.
Methods
FC records of eleven adult and seven pediatric patients with non-treated primary ITP from our database were enrolled for retrospective analysis. Different types of hematopoietic progenitor cells, B-lineage, myeloid and nucleated erythroid cells of different maturity were counted in BM of patients with ITP using several eight-color staining protocols and multi-parametric FC analysis. The data from ITP patients were compared with the data from hematologically normal adult (n=29) and pediatric (n=7) BM.
Results
Differential count of BM cells by FC detected the elevated numbers of total CD34+ hematopoietic progenitors, CD34+/cytoCD79a+/nuTdT+ B-lineage progenitors, CD34+/CD33+ committed myeloid progenitors and probable increase of early erythroid progenitors (erythroblasts) in adult patients with ITP when compared with normal adult BM and BM from patients with idiopathic cytopenia of undetermined significance as pathological control. FC showed an increased fraction of CD10+/CD20+/nuTdT- immature B cells and increase of total population of B cells in BM of adult patients with ITP. In contrast to adult patients, a reduced number of B cells was found in BM of pediatric patients with ITP, and it resulted from decrease of B-cell progenitors and immature B cells. FC revealed no other significant differences between BM of pediatric patients with ITP and age-related controls.
Summary
The present data suggest an acceleration of hematopoiesis in adult patients with ITP and address the question of its potential role in the pathogenesis of disease. Opposite changes in the composition of BM B cells in adults and children may reflect a different pathogenetic role of B cells and BM lymphopoiesis in the adult and pediatric ITP.
Keyword(s): Bone Marrow, Flow cytometry, Hematopoiesis, Immune thrombocytopenia (ITP)
Type: Publication Only
Background
Immune thrombocytopenia (ITP) is a clinically and pathogenetically diverse autoimmune disorder resulted from antibody and/or T-cell mediated destruction of platelets and insufficient platelet production by immunologically affected megakaryocytes. The studies of bone marrow (BM) hematopoiesis in ITP show morphologically normal marrow with increased number of megakaryocytes in many patients. Abnormal levels of plasma thrombopoietin, interleukin 6 and some other hematopoietic cytokines were recently reported in patients with ITP, and these suggested a disorder of cytokine regulation with possible consequences for BM hematopoiesis. BM examination is usually unnecessary for patients with ITP, but flow cytometry (FC) study of BM is needed in some thrombocytopenic patients to exclude non-immune causes of cytopenia. The data of multi-parametric FC analysis in these patients represent a good opportunity to determine morphologically undetectable abnormalities in BM hematopoiesis at ITP.
Aims
The aim of current study was to examine hematopoiesis in patients with ITP by FC analysis of their BM.
Methods
FC records of eleven adult and seven pediatric patients with non-treated primary ITP from our database were enrolled for retrospective analysis. Different types of hematopoietic progenitor cells, B-lineage, myeloid and nucleated erythroid cells of different maturity were counted in BM of patients with ITP using several eight-color staining protocols and multi-parametric FC analysis. The data from ITP patients were compared with the data from hematologically normal adult (n=29) and pediatric (n=7) BM.
Results
Differential count of BM cells by FC detected the elevated numbers of total CD34+ hematopoietic progenitors, CD34+/cytoCD79a+/nuTdT+ B-lineage progenitors, CD34+/CD33+ committed myeloid progenitors and probable increase of early erythroid progenitors (erythroblasts) in adult patients with ITP when compared with normal adult BM and BM from patients with idiopathic cytopenia of undetermined significance as pathological control. FC showed an increased fraction of CD10+/CD20+/nuTdT- immature B cells and increase of total population of B cells in BM of adult patients with ITP. In contrast to adult patients, a reduced number of B cells was found in BM of pediatric patients with ITP, and it resulted from decrease of B-cell progenitors and immature B cells. FC revealed no other significant differences between BM of pediatric patients with ITP and age-related controls.
Summary
The present data suggest an acceleration of hematopoiesis in adult patients with ITP and address the question of its potential role in the pathogenesis of disease. Opposite changes in the composition of BM B cells in adults and children may reflect a different pathogenetic role of B cells and BM lymphopoiesis in the adult and pediatric ITP.
Keyword(s): Bone Marrow, Flow cytometry, Hematopoiesis, Immune thrombocytopenia (ITP)
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