In vitro Culture of Leukaemic Cells from 81 Patients with Acute Leukaemia

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Abstract
Bone marrow and/or blood cells from 81 patients with acute leukemia, including 50 patients with acute myeloid leukemia, were cultured in vitro using the agar culture method. The cells were cultured in a single layer assay or a normal source of colony stimulating factor (CSF) included in the culture. In almost all cases an abnormal growth pattern was seen, ranging between no growth and an excessive number of clusters. Immature granulocytic cells and macrophages were the dominating cell types in clusters and colonies from 14 of 16 patients with acute myeloid leukemia. In patients with acute myeloid leukemia the remission induction rate was related to the cluster incidence. Thus, 75% of the patients with a cluster incidence from 0-100 obtained a complete remission (CR), while only 31% of the patients with a high cluster incidence (> 1000/2 .times. 105 cells) obtained a remission. Cluster formation in unstimulated cultures of CSF sensitive cells did not seem to be of prognostic value. The correlation between prognosis and in vitro growth in patients with acute myeloid leukemia stresses the need of obtaining more insight in those factors, other than drug sensitivity, which are of importance for the therapeutic response.