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Cytokine Concentrations in Bone Marrow of Stable Sickle Cell Anemia Patients
  1. Gail Dallalio1,
  2. Chris Y. Brunson1,
  3. Robert T. Means Jr1
  1. From the Hematology/Oncology Divisions Department of Veterans Affairs Medical Center and the University of Kentucky/Markey Cancer Center (G.D., R.T.M.), Lexington, KY; and the Medical University of South Carolina and Ralph H. Johnson VA Medical Center (C.Y.B.), Charleston, SC.
  1. Supported by grant HL69418 from the US National Institutes of Health and by funds from the Medical Research Service, US Department of Veterans Affairs.
  2. Presented in part at the Southern Societies Clinical Research Meeting. New Orleans, LA, February 24, 2005.
  3. Address correspondence to: Dr. Robert T. Means Jr, Medical Service (111), VA Medical Center Room A429, 1101 Veterans Drive, Lexington, KY 40502; e-mail: robert.means{at}


Inflammation plays a significant role in the clinical manifestations of sickle cell anemia. In studies of anemic patients with other clinical syndromes, measurement of the concentrations of cytokine mediators of inflammation in bone marrow aspirates has provided unique correlations with clinical and laboratory parameters. We determined concentrations of interleukin (IL)-1, IL-6, tumor necrosis factor (TNF), and placental growth factor (PlGF) in bone marrow aspirates from six homozygous sickle cell (SS) patients who were not acutely ill and who were not receiving hydroxyurea, erythropoietin, or chronic transfusion and compared them with specimens from seven healthy controls. We also measured concentrations of soluble transferrin receptor (sTfR) and of marrow erythroid colony-forming units (CFU-E) as markers of erythropoietic activity. sTfR concentration was significantly higher in SS patients (p = .024). CFU-E concentration was not significantly different between the two groups. Bone marrow concentrations of IL-6 and IL-1 did not differ between the study groups. TNF was undetectable in all specimens, plasma or marrow. Bone marrow PlGF concentrations were significantly higher in SS patients (p = .004). Since PlGF is a product of erythroid cells, the ratio of marrow PlGF to marrow sTfR was determined and found to be significantly greater in SS patients. This suggests that the observed difference in marrow PlGF concentrations does not reflect increased erythropoiesis but rather represents increased PlGF production per erythroid unit.

Key words
  • sickle cell anemia
  • inflammation
  • erythropoiesis
  • cytokines
  • placental growth factor
  • apoptosis

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