Human Preleukemia

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Abstract
The proliferation and maturation of bone-marrow cells from four patients with preleukemia were studied in vitro with the use of a liquid culture technic. Viable cell counts and 3H-thymidine labeling indexes were similar in preleukemia, acute myelogenous leukemia and normal marrow cultures. Cellular maturation, however, was delayed in the patients with preleukemia and delayed or absent in acute leukemia, resulting in the appearance of a morphologically homogeneous population of immature cells early in culture. Maturation was normal in cultures of bone marrow from three patients with refractory anemia and from three with chronic myelocytic leukemia. These data provide evidence supporting a concept of acute myelogenous leukemia as a primary disturbance of cellular maturation. The technic of bone-marrow culture in liquid medium may be useful in identifying the preleukemic state in man. (N Engl J Med 288:1083–1086, 1973)