ISSN 2997-1036
International Journal of Hematology | Vol. 9, No. 5, May 2018 | pp. 33–40
DOI: 10.46882/2018/IJH/000101
Original Article
Title: Serum cytokine kinetics and bone marrow apoptotic indices in patients with severe aplastic anemia
Names of Authors: A. I. Ibrahim¹, C. D. Balogun², E. O. Ojo³
Authors’ Affiliations: ¹Department of Haematology, Ahmadu Bello University, Zaria, Nigeria; ²Department of Medicine, University of Ilorin, Ilorin, Nigeria; ³Department of Chemical Pathology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
Abstract: Immune-mediated bone marrow failure is heavily driven by T-cell-induced apoptosis of hematopoietic progenitor lines. This prospective study evaluated serum tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) kinetics alongside bone marrow CD34+ cell apoptotic indices in 38 newly diagnosed adult patients with severe aplastic anemia. Serum cytokine levels were quantified using an enzyme-linked immunosorbent assay, while flow cytometry determined the annexin-V positivity rates on harvested bone marrow CD34+ stem cells. Patients with severe aplastic anemia exhibited significantly elevated baseline serum IFN-gamma (42.6 ± 8.4 pg/ml) and TNF-alpha (68.4 ± 12.2 pg/ml) concentrations compared to healthy controls (P < 0.001). Apoptotic markers on CD34+ precursors were markedly elevated, with a mean index of 48.5 ± 6.4% versus 4.2 ± 1.1% in control pools. High baseline cytokine levels correlated inversely with absolute neutrophil counts (r = -0.54, P < 0.01). Following 12 weeks of immunosuppressive therapy with cyclosporine-A, responsive patients demonstrated a significant reduction in serum IFN-gamma levels corresponding to a recovery in peripheral blood counts. Tracking serum cytokine kinetics offers an accessible, non-invasive diagnostic monitor for evaluating microenvironmental immune stress and therapeutic responses in bone marrow failure syndromes.
Keywords: Aplastic anemia, interferon-gamma, tumor necrosis factor-alpha, apoptosis, bone marrow failure
Manuscript Timeline: Received: February 10, 2018; Revised: March 18, 2018; Accepted: April 05, 2018; Published: May 14, 2018