MARROW CULTURE STUDIES IN ADULT ACUTE-LEUKEMIA AT PRESENTATION AND DURING REMISSION

Abstract

Culture of bone marrow and/or blood cells in a semisolid agar system from 43 adults with acute nonlymphoblastic leukemia at 1st presentation showed 2 distinct growth patterns at 14 days. In 53% of patients cells failed to grow (type O), while in the remainder an abnormal growth pattern (type B) with small numbers of diffuse colonies and excessive numbers of cell clusters was seen. The response following chemotherapy was significantly better in the patients whose cells failed to grow. Serial culture studies, performed in 9 patients throughout remissions of 100-1112 days, which were maintained by intermittent chemotherapy, showed wide fluctuations in proliferative activity. These ranged from no growth to marked proliferation with predominance of clusters and small numbers of diffuse colonies, indistinguishable from the type B pattern seen in 47% of patients at 1st presentation. The possibility is discussed that the periods of fialure to grow, and/or those in which a type B pattern emerged, represented sporadic reactivation of leukemic cells.