Studies on hematopoietic stem cells: XI. Lack of erythroid burst-forming units (BFU-E) in patients with aplastic anemia.

The marrow concentration of erythropoietic precursors was examined in normal donors and patients with idiopathic aplastic anemia using a plasma clot culture system. On time course observations the heterogeneity of human erythroid precursors assayable in culture was demonstrated. To evaluate human erythropoiesis in vitro, the benzidine-positive colonies were divided into three groups: small colony, containing 8-50 cells; medium-sized colony, containing 50-500 cells; and large colony, containing more than 500 cells. The majority of the large colonies assumed the morphology of erythropietic bursts (BFU-E) consisted of several subcolonies. The small colonies were counted as CFU-E1, the medium-sized as CFU-E2, and the large as BFU-E to evaluate the erythroid precursor cell compartment in aplastic anemia. The marrow concentration of CFU-E1 and CFU-E2 was shown to be quantitatively diminished in aplastic anemia. In addition, there was no ability of the marrow cells from aplastic patieints to grow BFU-E in vitro even in the presence of a large dose of erythropoietin. This lack of BFU-E colony growth may play an important role in the mechanism of the erythropoietic deficiency in aplastic anemia.