A new test for both neutrophil marrow reserves and intravascular survival.

Reinfusion of a patient's own blood through a hemodialysis coil causes neutrophilia, reaching a peak less than 1 hour after starting the blood reinfusion and returning to baseline count over the next few hours, resulting from a transient release of neutrophils from the bone marrow. This report gives data regarding the double clinical utility of so stimulating a patient's marrow. First, we found that the magnitude of this neutrophilia was a good measure of marrow neutrophil reserves, as determined by comparison with the marrow mature neutrophil cellularity. Second, the falloff from peak neutrophilia to baseline count was a good estimate of neutrophil intravascular survival, as determined by comparison with the standard, in vitro, diisopropylfluorophosphate (DF32P) survival procedure. Thus, this one test could detect abnormalities both of marrow neutrophil production (release) and of peripheral destruction. The coil test requires no radioactive isotope, utilizes commonly available equipment, is apparently harmless and acceptable to the patients, and can be greatly simplified by the development of a blood bag containing sterile cellophane. Even in its present form, it offers considerable clinical and economic advantages in the assessment of pathophysiology of neutropenia in individual patients.