HUMAN LONG-TERM BONE-MARROW CULTURE AS A PROGNOSTIC FACTOR FOR HEMATOPOIETIC RECONSTITUTION IN AUTOLOGOUS TRANSPLANTATION

Human long-term bone marrow cultures allow persistence of hematopoetic stem cells in vitro for several weeks. Abnormalities in these culture s have been observed after cell treatment for purging in vitro. In aut ologous transplantation trials an increase in grafting failures after purging has also been reported. These results suggest a correlation be tween culture behaviour and graft kinetics. We analyzed the pattern of growth in Dexter culture of the bone marrow fraction infused in 52 pa tients with malignant diseases and subjected to autologous transplanta tion. In 23 cases, bone marrow cells had previously been treated in vi tro with Asta-Z 7654 (n = 7) or with monoclonal antibodies plus comple ment (n = 16). Some of the long-term bone marrow culture parameters se emed to correlate with grafting kinetics, mainly adherent cell layer d evelopment and persistence of committed hematopoietic progenitors (CFU -GM) in the supernatant cells. The absence of a stromal layer defined a group with very poor hematological recovery after transplantation. N ine cases were included in this group and only one patient (11%) had r ecovered granulocytes and platelets. However, 90% of patients whose lo ng-term cultures displayed normal adherent cell behavior had recovered peripheral hematological values. These results suggest that long-term bone marrow cultures could be used as a prognostic factor for hematop oietic reconstitution in autologous transplantation.