[Immune related pancytopenia: a new type of bone marrow failure]

Being enlightened by the idea of "accurate medicine", we analyzed" aplastic anemia sydrome"and found that the "refractory cases" that did not respond to T-cell immunotherapy included a group of bone marrow failure with abnormal humoral immune damage or suppression of bone marrow hematopoiesis, which was named "immune related pancytopenia (IRP)". Those cases were characterized by having such manifestations as follows: pancytopenia with normal or higher percentages of reticulocyte or/and neutrophil in peripheral blood cell count; lower or normal proliferation of bone marrow cells with lower percentage of lymphocyte, and erythrocyte-island and no-dysplasia are easily seen; positive autoantibodies on bone marrow cells, higher percentages of B1 cell or plasma cell, elevated serum level of type Ⅱ lymphokines, more activations of B cells and plasma-dendritic cells (P-DC), and much successful response to immune suppression therapy targeting on humoral immunity. Identifying such diseases is conductive to increase the diagnosis accuracy of bone marrow failure and improve the therapeutic response, which provides a basis for in-depth study of its etiology and provides a reference for the study of other related diseases.