Abstract
Study of neutrophil granulocyte kinetics following the reinfusion of autologous DFP<sup>32</sup>-labelled granulocytes in man allows one to interpret the dynamic abnormalities of granulopoiesis in a wide variety of clinical disorders. The size of the total blood granulocyte pool (TBGP) can be calculated from the number of labelled granulocytes infused and the number found initially in the circulation, using isotope dilution principles. The TBGP is always greater than the circulating granulocyte pool (CGP), due to the presence of granulocytes marginated on the walls of vessels (the margined granulocyte pool, MGP). Granulocytes disappear from the blood in s random fashion, which can be characterized by the half disappearance time (T½) of labelled granulocytes in the blood. The granulocyte turnover rate (GTR) can be derived from the TBGP and the T½. In a steady-state situation the GTR is equal to the rate at which granulocytes are produced by the marrow. The authors used these techniques to study two groups of patients: (a) those with lymphoma, and (b) those with neutropenia due to non-malignant disease. Six of the 8 patients with lymphoma had splenamegaly at the time of study, and 4 of thesr were neutropenic. Five of the 7 other patients with neutropenia also had splenomegaly (three Felty's syndrome, one DLE, one portal hypertension). The majority of patients with splenomegaly had an increased MGP : CGP ratio, but none showed a significant shortening of granulocyte survival. In most cases, granulocytes were being produced at a normal or greater than normal rate. Two patients with splenomegaly (one with lymphoma, one with Felty's syndrome) underwent splenectomy, with an increase in circulating granulocytes in each case. Results in 2 patients with lymphoma without splenomegaly were essentially normal, while 2 patients with neutropenia without splenomegaly showed a normal granulocyte survival, a decrease in granulocyte production and an increase in the MGP CGP ratio.
Published Version
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