The kinetic behaviour of transfused donor bone marrow neutrophils and their precursors in neutropenic patients.

Abstract

Summary. Six neutropenic patients (eight studies) with hypo‐ or aplastic bone marrow (BM) received 3H‐thymidine (3H‐TdR) and/or 32P‐diisopropylfluorophosphate (DF32P) labelled donor BM cells intravenously. The donor‐recipient leucocyte histocompatibility (HL‐A) match was A in three studies, B in one study and C in another four studies. Leucocyte specific activity (LSA) and autoradiography of serial blood and BM specimens were used to follow the behaviour of the labelled donor neutrophilic cells in the recipient. In two patients (three studies), who received HL‐A A and B matched cells, the donor neutrophil precursors were shown to divide and feed mature cells into the circulation for 10–11 days. The pattern of the entry of labelled segmented neutrophils into the blood was similar to the patterns noted after the i.v. injection of these isotopes in normal individuals except for the rapid emergence of the 3H‐TdR labelled cells into the blood and shortening in all the three phases of the DF32P LSA curves. Studies of this type can be used as an aid in the rapid evaluation of the fate of the donor's transplanted mitotable granulocytic cells in the recipient. Labelled donor cells did not survive in the other patients.Repopulation of the BM did not ensue in the two patients (three studies) with ideal donor‐recipient pairing (identical twins, negative serum cytotoxicity tests), perhaps due to persisting infectious hepatitis virus or effects therefrom in one patient whose BM aplasia followed infectious hepatitis.