Transient suppression of clonal hemopoiesis associated with pregnancy in a patient with a myeloproliferative disorder

J Clin Invest. 1988 Jun;81(6):1999-2003. doi: 10.1172/JCI113549.

Abstract

We have used restriction fragment length polymorphism analysis to study the clonal involvement of the blood cells in a woman with myeloproliferative disease, whose initially high platelet count (940,000/microliter) spontaneously decreased during a normal pregnancy but then returned rapidly to the same high level after delivery of her child. Analysis of her erythroid progenitors showed the presence of erythropoietin-independent progenitors before, during, and after her pregnancy, consistent with a diagnosis of myeloproliferative disease, and persistence of the abnormal clone throughout the period of study. Analysis of DNA from her blood granulocytes showed these to be polyclonal at mid-pregnancy, when her platelet count had decreased to normal values, in comparison to the monoclonal pattern exhibited by her blood granulocytes 3 mo postpartum, when her platelet count was again elevated. These results demonstrate a partial conversion to normal, polyclonal hemopoiesis during her pregnancy and suggest a previously unanticipated differential sensitivity of normal and neoplastic hemopoietic cells to physiological changes associated with this state.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Platelets*
  • Cell Count
  • Clone Cells
  • DNA / analysis
  • Female
  • Fibroblasts
  • Granulocytes
  • Hematopoiesis*
  • Hematopoietic Stem Cells
  • Humans
  • Myeloproliferative Disorders / blood
  • Myeloproliferative Disorders / genetics
  • Myeloproliferative Disorders / physiopathology*
  • Neoplastic Stem Cells
  • Nucleic Acid Hybridization
  • Platelet Count
  • Polymorphism, Restriction Fragment Length
  • Pregnancy
  • Pregnancy Complications, Hematologic / blood
  • Pregnancy Complications, Hematologic / physiopathology*

Substances

  • DNA