Burst-forming unit-erythroid assays to distinguish cellular bone marrow failure disorders

Amy E. DeZern, Jeffrey Pu, Michael A. McDevitt, Richard J. Jones, Robert A. Brodsky

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Patients with cytopenias and a cellular bone marrow can be a diagnostic and therapeutic challenge. Previous reports suggested a role for progenitor assays for diagnosis and predicting response to therapy. We report the results of Burst-forming unit-erythroid (BFU-E) assays in 48 consultative cases of single or multilineage cytopenias with cellular marrows. The final diagnoses included 17 patients with myelodysplastic syndrome, 9 patients with pure red cell aplasia (non-large granular lymphocytosis [LGL] in etiology], 15 patients with LGL (eight of whom had a single-lineage cytopenia only, whereas the other seven had multilineage cytopenias), and 7 patients with cytopenias associated with systemic inflammation from autoimmune conditions. In this cohort, nonmalignant diseases were well-distinguished from myelodysplastic syndrome by BFU-E growth. Our data suggest that low BFU-E growth (less than 10 BFU-E per 105 marrow mononuclear cells) helps to exclude LGL, pure red cell aplasia, or cytopenias associated with systemic inflammation as a cause of pancytopenia with a sensitivity of 96.8%, specificity of 76.5%, and a predictive value of 88.2% (p = 0.0001). BFU-E growth also was examined to predict treatment response. Of the 29 patients in this cohort treated with immunosuppressive therapy, there was an 86% response rate with 25 responders (11 partial responses and 14 complete responses) and 4 nonresponders. This result correlated with higher BFU-E growth. Our results suggest that BFU-E assays are a useful adjunct in the diagnosis and management of cytopenias in the setting of a normocellular or hypercellular marrows.

Original languageEnglish (US)
Pages (from-to)808-816
Number of pages9
JournalExperimental Hematology
Volume41
Issue number9
DOIs
StatePublished - Sep 1 2013

Fingerprint

Erythroid Precursor Cells
Bone Marrow
Large Granular Lymphocytic Leukemia
Pure Red-Cell Aplasia
Myelodysplastic Syndromes
Growth
Inflammation
Lymphocytosis
Pancytopenia
Therapeutics
Immunosuppressive Agents
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Cancer Research
  • Cell Biology
  • Genetics
  • Molecular Biology
  • Hematology

Cite this

DeZern, Amy E. ; Pu, Jeffrey ; McDevitt, Michael A. ; Jones, Richard J. ; Brodsky, Robert A. / Burst-forming unit-erythroid assays to distinguish cellular bone marrow failure disorders. In: Experimental Hematology. 2013 ; Vol. 41, No. 9. pp. 808-816.
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Burst-forming unit-erythroid assays to distinguish cellular bone marrow failure disorders. / DeZern, Amy E.; Pu, Jeffrey; McDevitt, Michael A.; Jones, Richard J.; Brodsky, Robert A.

In: Experimental Hematology, Vol. 41, No. 9, 01.09.2013, p. 808-816.

Research output: Contribution to journalArticle

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