In Vitro Tests for Distinguishing Possible Immune-Mediated Aplastic Anemia From Transfusion-Induced Sensitization

• Published in: Blood Vol. 55; no. 2; pp. 211 - 215
• Main Authors: Torok-Storb, Beverly J., Sieff, Colin, Storb, Rainer, Adamson, John, Thomas, E. Donnall
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.1980
• Subjects: Anemia, Aplastic - immunology; Animals; Blood Transfusion; Cell Differentiation; Cells, Cultured; Erythrocytes - cytology; Erythrocytes - immunology; HLA Antigens; Humans; Immunization; Lymphocytes; Rosette Formation; Sheep
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V55.2.211.211

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.