Chikkappa G, Chanana A D, Chandra P, Cronkite E P, Thompson K H
Blood. 1980 Jan;55(1):61-6.
A patient with multiple myeloma developed periodic blood neutropenia (periodicity of 15-25 days) after 3 yr of intermittent treatment with cytotoxic agents. Peaks of serum colony-stimulating activity (CSA) level coincided with valleys of blood neutrophils. Fraction of marrow neutrophils in the multiplicative pool was high during blood neutrophil valleys and low during neutrophil peaks. In contrast, the maturation storage pool exhibited the reverse pattern. An increased fraction of marrow neutrophilic cells in the multiplicative pool was in active proliferation during a blood neutrophil valley and a decreased fraction during a blood neutrophil peak. These findings suggest that the marrow granulopoiesis was regulated through CSA. The defect causing the periodicity was probably related to the reduced number of neutrophils in the marrow maturation storage pool, which in turn may be related to a reduced and/or defective granulocytic stem cell pool size consequent to the long-term administration of cytotoxic drugs and/or infiltration of the marrow by myeloma cells.
一名多发性骨髓瘤患者在接受细胞毒性药物间歇治疗3年后出现周期性血液中性粒细胞减少（周期为15 - 25天）。血清集落刺激活性（CSA）水平的峰值与血液中性粒细胞的谷值一致。在血液中性粒细胞谷值期间，骨髓中增殖池的中性粒细胞比例较高，而在中性粒细胞峰值期间则较低。相反，成熟储存池呈现相反的模式。在血液中性粒细胞谷值期间，增殖池中骨髓嗜中性细胞的比例增加且处于活跃增殖状态，而在血液中性粒细胞峰值期间比例下降。这些发现表明骨髓粒细胞生成是通过CSA调节的。导致周期性的缺陷可能与骨髓成熟储存池中中性粒细胞数量减少有关，而这反过来可能与长期使用细胞毒性药物和/或骨髓瘤细胞浸润骨髓导致粒细胞干细胞池大小减少和/或缺陷有关。
