Granulocyte-macrophage colony-forming-unit assay and liquid suspension culture of bone marrow and peripheral blood in newly diagnosed childhood acute lymphoblastic leukemia

Der Cherng Liang, Shu Huey Chen, Hsi Che Liu, Shu Fang Yu, Mei Chuang Kuo

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Granulocyte-macrophage colony-forming-unit (CFU-GM)-assays and/or liquid suspension cultures of bone marrow (BM) and peripheral blood (PB), using human placental conditioned medium as a source of colony-stimulating activity, were performed in 125 children with newly diagnosed acute lymphoblastic leukemia (ALL). Unlike the previous small series which invariably showed poor BM granulocyte-macrophage colony and cluster formations, we found 3 growth patterns. A poor-growth pattern was seen in 101 patients. A low-growth pattern with BM colony and cluster formations in the lower range of the normal limits was observed in 6 patients. All 6 patients had low-risk ALL, and the in vitro growth may reflect the residual normal CFU-GM in BM. Thirdly an over-growth pattern was noted in one patient with refractory ALL. In 49 cases where liquid suspension cultures of BM were performed, 4 had a normal-growth pattern and 42 had apoptotic cells and/or few residual granulocytic/monocytic cells after 7 days of culture. However, in both B cell ALL cases and in 1 refractory T cell ALL case with hyperleukocytosis, repetitive liquid suspension cultures of BM and PB consistently revealed an extensive growth of lymphoblasts. Thus, an over-growth pattern in either the BM CFU-GM assay or liquid suspension culture of BM or PB in children with ALL at diagnosis may indicate a refractory or aggressive disease. A low-growth pattern in the BM CFU-GM assay in children with ALL at diagnosis probably predicts a favorable outcome.

Original languageEnglish
Pages (from-to)12-16
Number of pages5
JournalActa Haematologica
Issue number1
Publication statusPublished - 1998
Externally publishedYes



  • Bone marrow
  • Childhood acute lymphoblastic leukemia
  • Granulocyte-macrophage colony-forming-unit assay
  • Liquid suspension culture
  • Peripheral blood

ASJC Scopus subject areas

  • Hematology

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