The Determination Of CD₃₄ Positive Cells And Granulocyte Colony-Stimulating Factor Receptors On CD₃₄ Positive Cells In Bone Marrowof The Patients With Aplastic Anemia And Myelodysplastic Syndrome

Objective: To detect the ratio of CD₃4 positive cells in bone marrow mononuclear cells and the expressive rate of G-CSFR on CD₃4 positive cells in bone marrow of the patients with aplastic anemia (AA) and myelodysplastic syndrome (MDS), so to explore whether CD₃4 positive cells and the expressive rate of G-CSFR on CD₃4 positive cells involved in the pathogenesies of AA and MDS, to reveal different pathogenesies between AA and MDS, that gives a new way for us to diagnose and distinguish AA and MDS ,direct the therapy.Method: 13 AA patients, 22 MDS patients and 12 normal subjects were respectively taken 2ml bone marrow samples by conventional bone marrow puncture. To separate bone marrow mononuclear cells with gradient centrifugation, to detect the ratio of CD₃4 positive cells in bone marrow mononuclear cells and the expressive rate of G-CSFR on CD₃4 positive cells by flow cytometry (FCM) and monoclonal antibody technique, to count neutrophil population in peripheral blood on diagnosis and analyse the relationship beween the ratio of CD₃4 positive cells in bone marrow mononuclear cells and the expressive rate of G-CSFR on CD₃4 positive cells and neutrophil population in peripheral blood.Results:1. There was significant difference according to the ratio of CD34 positive cells in mononuclear cells of bone marrow between AA group and control group.(AA group0.2562% ± 0.2213%; control group 1.1833% ± 0.4862%,;? < 0.05)2. There was no significant difference according to the ratio of CD34 positive cells in mononuclear cells of bone marrow between MDS group and control group.(MDS group 2.2350% ± 2.6955%; control group 1.1833% ± 0.4862%,p)0.05)3. There was no significant difference according to the ratio of CD34 positive cells in mononuclear cells of bone marrow between myelodysplastic syndrome -refractory anemia (MDS-RA) group and control group. (MDS-RA group0.7825%± 0.5171%; control group 1.1833%± 0.4862%, p > 0.05)4. There was significant difference according to the ratio of CD34 positive cells in mononuclear cells of bone marrow between myelodysplastic syndrome -refractory anemia with excess of blasts (MDS-RAEB) group and control group. (MDS-RAEB group 3.9780% ± 3.2308%; control group 1.1833% ± 0.4862%,p(0.05)5. There was significant difference according to the ratio of CD34 positive cells in mononuclear cells of bone marrow between AA group and MDS group. (AA group0.2562%± 0.2213%; MDS group 2.2350%± 2.6955%, p < 0.05)6. There was significant difference according to the ratio of CD34 positive cells in mononuclear cells of bone marrow between MDS-RA group and MDS-RAEB group. (MDS-RA group 0.7825% ± 0.5171%; MDS-RAEB group 3.9780% ± 3.2308%,p <0.05)7. There was no significant difference according to the expressive rate of G-CSFR on CD34 positive cells in bone marrow between AA group and control group.(AA group 34.402% ± 21.8357%; control group 21.44%± 7.4465%, p > 0.05)8. There was no significant difference according to the expressive rate of G-CSFR on CD34 positive cells in bone marrow between MDS group and control group.(MDS group 26.376% ± 15.2895%; control group 21.44%± 7.4465%, p > 0.05)9. There was no significant difference according to the expressive rate of G-CSFR on CD34 positive cells in bone marrow between AA group and MDS group. (AA group 34.402%± 21.8357%; MDS group 26.376%± 15.2895%, p > 0.05)10. There was no significant difference according to the expressive rate of G-CSFR on CD34 positive cells in bone marrow between MDS-RA group and MDS-RAEB group. (MDS-RA group 22.788 ± 14.7628; MDS-RAEB group 30.682± 15.5346, p > 0.05)11. The ratio of CD34 positive cells in mononuclear cells of bone marrow was less than 0.1% in the majority of SAA patients (3/4) while the ratio of CD34 positive cells in mononuclear cells of bone marrow was seldom less than 0.1% in CAA patients (1/9).There was no correlation between the expressive rate of G-CSFR on CD34 positive cells in bone marrow and neutrophil population in peripheral blood on diagnosis (r =0.058).12. Most MDS patients (7/9) with low G-CSFR expression had neutropenia of the peripheral blood. Neutropenia was less common in the normal group (1/6), but also occurred in the high expression group (3/7). There was no correlation between the ratio of CD34 positive cells in mononuclear cells of bone marrow and neutrophil population in peripheral blood on diagnosis (r =-0.335).Conclusion:1. AA patients showed markedly reduced number of CD34 positive cells in bone marrow, and SAA patients had lower number of CD34 positive cells in bone marrow than CAA patients. It illustrated that the impairment of haemopoietic stem cells was one of the principal pathogenesies of AA, and the degree of the reduced number of CD34 positive cells in bone marrow was correlated with pathogenetic conditions. So the determination of CD34 positive cells can be used in clinical to diagnose AA, judge pathogenetic condition and direct treatment.2. There were no obvious changes in the number of CD34 positive cells in bone marrow of MDS-RA patients, while the number of CD34 positive cells in bone marrow of the MDS-RAEB patients was extremely high. It suggested that the increased ratio of CD34 positive cells in bone marrow of MDS patients maybe was a poor prognostic indicator.3. The number of CD34 positive cells in bone marrow of A A patients was abnormally lower than that of MDS patients. It demonstrated that their pathogenesies was different and the determination of CD34 positive cells was helpful to distinguish AA and MDS.4. There were no obviously changes in the expressive rate of G-CSFR on CD34 positive cells in bone marrow of AA patients and there was no correlation between the expressive rate of G-CSFR on CD34 positive cells in bone marrow and neutrophil population in peripheral blood on diagnosis. It showed that the expressive rate of G-CSFR on CD34 positive cells in bone marrow wasn't a chief influencing factor of AA.5. Most MDS patients with low G-CSFR expression had neutropenia of the peripheral blood. Neutropenia was less common in the normal group, but also occurred in the high expression group. It can partly explain why MDS patients have neutropenia of the peripheral blood.