Granulopoiesis in Acute Myeloid Leukemia and Preleukemia

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Abstract
In vitro regulation of granulocytic proliferation and differentiation was analyzed by study of marrow granulocytic colony-forming capacity (CFC) and peripheral white-cell provision of colony-stimulating activity (CSA) in patients with acute myeloid leukemia (AML) and preleukemia. Patients with AML in relapse had abnormal marrow CFC, producing either no or excessive numbers of abortive colonies. Furthermore, their leukocytes lacked ability to provide CSA. During complete remission, both these indexes were normal. Sequential studies indicated that marrow CFC correlates with, and probably precedes, detectable changes in clinical and morphologic status. Preleukemic patients showed disordered CFC and CSA, with values similar to those in AML in relapse. AML marrow appears to consist of coexisting normal and leukemic cell clones, and preleukemic marrow to contain either a potentially leukemic clone with greater capacity for differentiation in vivo or a leukemic clone that is held in abeyance.