Response to Treatment in Acute Non-lymphatic Leukaemia: Prognostic Value of Colony Forming and Colony Stimulating Capacities of Bone Marrow and Blood Cells Compared to Other Parameters

Abstract

Growth of bone marrow and mononuclear white blood cells (MWBC) in soft agar cultures was studied in 26 patients with untreated acute non-lymphocytic leukemia (ANLL). Marrow and MWBC from 30 healthy volunteers served as controls. All ANLL patients revealed an abnormal growth in vitro. Patients with an increased number of clones in marrow cultures and large cluster predominance (excessive growth) responded poorly to therapy with only 1 of 10 patients entering remission. Only 2 of the 15 patients with a decreased clone number (low growth) failed to achieve remission. Number of colonies and clusters in bone marrow and blood cultures was significantly lower at presentation in patients who later entered remission than in those who did not. Correlations between the number of colonies and clusters in the blood and the marrow cultures were statistically signifiant. No significant correlations were found between prognosis or colony formation, and production of colony stimulating activity (CSA), by bone marrow and blood cells of ANLL patients. Nor could such correlations be found between prognosis, blood cell counts and age. The growth pattern of bone marrow and circulating colony forming cells is of value in predicting the response to cytostatic drugs and in selecting patients with a high probability to respond poorly to current cytostatic regimes.