Experimental Study Of Immune-related Pancytopenia Syndrome

Objectives 1 ) To explore the type, distribution, quantity, and clinical significance of auto-antibodies on bone marrow hematopoietic cells in patients with immunorelated pancytopenia (IRP); 2) To evaluate the sensitivity of bone marrow mononuclear cell (BMMNC) Coombs tests. Methods The type and the positive rate of autoantibodies on bone marrow hematopoietic stem cells, nucleated erythrocytes, granulocytes of patients with suspected IRP were investigated with BMMNC-Coombs tests and flow cytometry double immunofluorescence assay.Results 1 ) The positive rate of auto-antibodies on bone marrow hematopoietic cells tested with flow cytometry was 90.63% which was significantly higher than that tested with BMMNC-Coombs test (50%). 2) In 29 cases with positive results, only IgG autoantibody positive cases accounted for 6.90%, only IgM accounted for13.8%, IgG+IgA accounted for 3.45%, IgG+IgM accounted for 31.0%, IgG+IgM+IgA accounted for 44.8%; 25 patients with IgG autoantibody accounted for 86.2%, 26 patients with IgM accounted for 89.7%, 14 patients with IgA accounted for 48.3%. 3) The patients only with IgG autoantibody had the most severe hemoglobin decrease, the patients with IgM autoantibody had the positive hemolytic findings, the response time of patients with IgM and IgG+IgM+IgA is shorter than that of the other patients. 4) 91.3% of the patients had auto-antibodies on bone marrow hematopoietic stem cells and presented with pancytopenia; 50% of the patients had auto-antibodies on nucleated erythrocytes and granulocytes, 11 of 13 pattients with negative BMMNC-Coombs tests had...