|
Diagnosis:
Acquired aplastic anemia
Patient M., male, born in 1977, was admitted to the Department of Hematology of Children Specialized Clinical Hospital No.14 on January 4, 1991, with diagnosis of hypoplastic anemia? Myelodisplastic syndrome? On admittance, the patient complained headache, vertigo, palpitation, dyspnea on insignificant load, bad appetite, expressed asthenia, skin paleness and hemorrhagic eruption, mainly on lateral surfaces of extremities.
Blood count on admittance: erythrocytes 2.4*1012/l; Hb 72 g/l; color index 0.9; leukocytes 2.4*109/l; erythrocytes, 2 %; n.p., 10 %; n.s., 19 % lymphocytes 54 %; monocytes 15 %; tr., 12*109/l; ESR 15 mm/hr. To verify the diagnosis, sternal puncture was made on January 24, 1991. Myelogram (Tables 2, 3) showed acute suppression of myeloid, erythroid growth, practical absence of megalokaryocyte growth. Diagnosis: acquired aplastic anemia.
On January 29, 1991, cryopreserved hematopoietic cells of human embryonic liver from one 10-week gestation embryo were transplanted intravenously. Total volume of cell suspension 3 ml; cell concentration 55*106/ml; CFU-GM count 78.6*103/ml.
On the 42nd day from the first transplantation of hematopoietic human embryonic liver cells, i.e. on March 12, 1991, hematopoietic cells of human embryonic liver from 8-week gestation embryo were transplantated: volume of cell suspension 4.5 ml; cell concentration 76.5*106/ml; CFU-GM count 60.8*103.
Myelograms on the 15th and 34th days from the second transplantation stated the improvement of hematopoiesis of all lines, including megalokaryocytic one. (see Tables 2,3).
The patient was discharged from the hematology clinic in better condition on the 37th day after repeated transplantation. The corticosteroid therapy was gradually discontinued; no transfusions of blood components were performed. At present, the patient follows active living style and is observed by hematologist; his condition is good.
Absolute contents of formed elements of bone marrow of patient M. before and after transplantation
| Index |
Prior to first transplantation, 109 in 1 l |
On the 9th day from first transplantation, 109 in 1 l |
On the 15th day from second transplantation, 109 in 1 l |
On the 24th day from second transplantation, 109 in 1 l |
| Neutrophilocytes |
|
|
|
|
promyelocytes
myelocytes
metamyelocytes
stab
segmented |
0.01
0.06
0.01
0.09 |
0.02
0.86
0.75
0.33
0.05 |
0.1
0.1
0.6
0.86
0.63 |
8.28
34.5
18.86
17.48
11.5 |
| Eosinophils segmented |
0.01 |
0.1 |
0.1 |
8.28 |
| Basophils segmented |
0.11 |
0.46 |
0.3 |
0.46 |
| Erythroblasts |
0.05 |
0.86 |
0.5 |
11.04 |
Normocytes
basophilic
polychromatophilic
oxyphilic |
0.136
0.07
0.004 |
1.13
2.33
0.06 |
0.8
2.3
0.16 |
20.24
53.36
10.12 |
| Lymphoblasts |
0.01 |
0.33 |
0.03 |
8.28 |
| Lymphocytes |
1.33 |
2.43 |
2.06 |
21.62 |
| Holonuclear |
0.1 |
0.06 |
0.26 |
5.52 |
| Plasmatic cells |
0.01 |
0.23 |
0.3 |
0.46 |
| Megakaryocytes |
0 |
Individual in preparation |
2:25 in visual field, nonfunctioning |
2:10000, functioning |
| Megakaryocytes |
2 |
10 |
10 |
230 |
Head of the Cell Therapy Clinic of National Medical University and Center "Emcell"
professor Alexander Smikodoub.
Blood indices in 12 years old patient M. suffering from aplastic anemia
| Date |
Erythrocytes, 1012/L |
Hemoglobin, g/l |
Leukocytes, 109/l |
Thrombocytes, 109/l |
ESR, mm/h |
Erythrocytes with fetal Hb (%) |
| 29.01.91 |
1 Fetal Cell Transplantation |
| 29.01.91 |
1.5 |
61 |
3.4 |
21 |
35 |
- |
| 30.01.91 |
1.9 |
61 |
2.1 |
22 |
20 |
0.2 |
| 1.02.91 |
2.1 |
70 |
1.6 |
- |
- |
0.2 |
| 5.02.91 |
2.1 |
72 |
2.4 |
16 |
65 |
- |
| 9.02.91 |
1.5 |
56 |
1.5 |
15 |
63 |
1.2 |
| 13.02.91 |
1.1 |
43 |
2.2 |
12 |
46 |
- |
| 23.02.91 |
2.3 |
80 |
2.9 |
- |
- |
2.7 |
| 11.03.91 |
2.5 |
94 |
2.4 |
32 |
40 |
3.2 |
| 12.03.91 |
1 Fetal Cell Transplantation |
| 15.03.91 |
1.5 |
60 |
2.5 |
21 |
- |
5.4 |
| 19.03.91 |
1.7 |
53 |
2.0 |
42 |
- |
11 |
| 11.04.91 |
2.6 |
75 |
2.9 |
93 |
48 |
13 |
| 29.04.91 |
2.3 |
88 |
4.1 |
116 |
8 |
12 |
| 20.05.91 |
3.4 |
132 |
3.4 |
230 |
5 |
19 |
| 3.06.91 |
4.0 |
150 |
3.8 |
230 |
3 |
27 |
| 13.02.92 |
3.6 |
154 |
5.1 |
230 |
2 |
27 |
|
