Stem cells and the microenvironment in aplastic anaemia

Normal blast colony-forming cells (BI-CFC) bind to stroma cultured in the presence of methylprednisolone (MP⁺) but not to MP^- stroma. In aplastic marrow, the incidence of BI-CFC is variable (0–4 x normal values) and there is no consistent relationship with the CFU-GM (granulocyte-macrophage colony-forming cell) content. Normal stroma require MP to induce BI-CFC binding function and form fat cells whereas MP^- stroma grown from 4/9 aplastic patients formed fat cells and bound BI-CFC. The 5/9 aplastic cases that did not form fat cells spontaneously also bound BI-CFC moderately better than normal stroma. This suggests that the haemopoietic microenvironment in aplastic anaemia responds physiologically to bone marrow failure by increasing its haemopoietic support capacity.