agar and Neutropenia

Topics: Agar; Anemia, Aplastic; Cell Count; Cell Differentiation; Clone Cells; Colony-Stimulating Factors; Culture Techniques; Hematopoiesis; Hematopoietic Stem Cells; Humans; Leukemia; Neutropenia

The susceptibility to levofloxacin of 194 consecutive staphylococcal (45 Staphylococcus aureus and 149 coagulase-negative staphylococci) isolates from neutropenic patients was determined by Etest and the results compared with those obtained using NCCLS-methods (broth microdilution, agar dilution and disk diffusion). Overall agreement at +/- 1log(2) dilution for Etest compared with broth microdilution and agar dilution was 99.0 and 83.5%, respectively. The Etest category agreement with broth microdilution and disk diffusion was 95.9 and 89.7%, respectively. Comparison of categories with Etest and agar dilution method gave only 67.0% absolute categorical agreement, with 29.9% minor errors and 10.7% major errors. No very major errors occurred by the four methods tested. Our results show that Etest is a valid alternative to the reference NCCLS-methods for monitoring the clinical usefulness of levofloxacin against staphylococci isolates from neutropenic patients.

Topics: Agar; Anti-Infective Agents; Culture Media; Diffusion; Drug Resistance, Microbial; Humans; Levofloxacin; Microbial Sensitivity Tests; Neoplasms; Neutropenia; Ofloxacin; Staphylococcus

Congenital neutropenia (CN), a disease characterized by recurrent infections leading to death in infancy, shows a maturation arrest of the myeloid series at the promyelocyte-myelocyte level. The potential value of marrow transplantation in this disease would be determined by the nature of the underlying defect. However, studies to date have failed to define whether the defect is intrinsic in the cells or attributable to "environmental" factors. Therefore, marrow of four patients with CN was cultured on soft agar, and the colonies were analyzed by a newly developed ultrastructural method. In parallel, patients' cells were used in feeder layers for normal marrow. Although the patients' colonies appeared grossly normal in size and number, electron microscopy showed only rare neutrophil colonies. These colonies contained markedly aberrant cells exhibiting asynchronous nucleocytoplasmic maturation, convoluted nuclei, excessive cytoplasm, and dearth of granules. Monocyte and eosinophil colonies differentiated normally. Patients' cells and sera supported growth of normal colonies. The studies have demonstrated unequivocally that the neutrophil cell line of patients with CN is intrinsically defective and suggest that attempts at marrow grafting are warranted.

Topics: Agar; Agranulocytosis; Bone Marrow; Bone Marrow Cells; Cells, Cultured; Eosinophils; Female; Humans; Male; Microscopy, Electron; Monocytes; Neutropenia; Plasma Cells

The use of in-vitro culture methods for studying human haemopoietic cells has advanced greatly since 1970. These methods have contributed to our understanding of the mechanisms controlling granulopoiesis though the physiological role of colony-stimulating factor needs further clarification. In leukaemia they offer an approach to the study of possible causal factors and to the characterisation of leukaemic-cell defects. Results already obtained support the concept that the bone-marrow in acute myeloid leukaemia consists of coexisting populations of normal and leukaemic cells, with a leukaemic clone predominating in relapse and normal clones regenerating in remission. For the individual patient, in-vitro methods may prove useful in assessing prognosis and in confirming the completeness of remission; the detection of early relapse may then indicate the need for changing or re-instituting therapy. Further studies may aid the classification of the "preleukaemic" states and may help in the identification of the various causes of neutropenia.

Topics: Agar; Bone Marrow; Bone Marrow Cells; Cell Division; Clone Cells; Colony-Stimulating Factors; Culture Media; Granulocytes; Hematopoiesis; Hematopoietic Stem Cells; Humans; Leukemia, Myeloid, Acute; Monocytes; Neutropenia

Bone marrow culture in semi-solid agar was used to assess the proliferative activity and the response to sodium aurothiomalate of the myeloid precursor cells from patients during and after recovery from neutropenia associated with the use of this drug. Colony formation was reduced during the neutropenia and returned to normal after recovery. The rheumatoid process itself did not impair colony formation even in patients with Felty's syndrome. Sodium aurothiomalate inhibited colony formation by normal marrow in a dose-dependent manner. Bone marrow colonies from patients who had recovered from neutropenia induced by sodium aurothiomalate were not abnormally sensitive to the inhibitory effect of the drug in vitro. The metabolism of gold is probably altered in a small proportion of patients, which causes high local concentrations within the bone marrow leading directly to marrow depression.

Topics: Adult; Agar; Aged; Agranulocytosis; Arthritis, Rheumatoid; Bone Marrow; Bone Marrow Cells; Cell Division; Clone Cells; Culture Techniques; Dose-Response Relationship, Drug; Felty Syndrome; Gold; Humans; Malates; Middle Aged; Neutropenia; Organometallic Compounds; Sulfides