From www.bloodjournal.org by guest on November 18, 2014. For personal use only. 1991 78: 2261-2268 Establishment and erythroid differentiation of a cytokine-dependent human leukemic cell line F-36: a parental line requiring granulocytemacrophage colony-stimulating factor or interleukin-3, and a subline requiring erythropoietin S Chiba, F Takaku, T Tange, K Shibuya, C Misawa, K Sasaki, K Miyagawa, Y Yazaki and H Hirai Updated information and services can be found at: http://www.bloodjournal.org/content/78/9/2261.full.html Articles on similar topics can be found in the following Blood collections Information about reproducing this article in parts or in its entirety may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#repub_requests Information about ordering reprints may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#reprints Information about subscriptions and ASH membership may be found online at: http://www.bloodjournal.org/site/subscriptions/index.xhtml Blood (print ISSN 0006-4971, online ISSN 1528-0020), is published weekly by the American Society of Hematology, 2021 L St, NW, Suite 900, Washington DC 20036. Copyright 2011 by The American Society of Hematology; all rights reserved. From www.bloodjournal.org by guest on November 18, 2014. For personal use only. Establishment and Erythroid Differentiation of a Cytokine-Dependent Human Leukemic Cell Line F-36: A Parental Line Requiring Granulocyte-Macrophage Colony-Stimulating Factor or Interleukin-3, and a Subline Requiring Erythropoietin By Shigeru Chiba, Fumimaro Takaku, Tsuyoshi Tange, Kyoichi Shibuya, Chie Misawa, Kiyoshi Miyagawa, Yoshio Yazaki, and Hisamaru Hirai KO Sasaki, We have established a new nonlymphoid leukemic cell line from a patient with myelodysplastic syndrome (MDS), which progressed t o overt leukemia. The parental cell line and a subline derived from this line have absolute dependency on several cytokines for their long-term survival and growth. The parental line designated F-36P requires granulocytemacrophage colony-stimulating factor (GM-CSF) or interleukin-3 (IL-3) for continuous growth, while a subline designated F-36E can be maintained in the presence of erythropoietin (Epo) alone. When these cytokines are depleted, both the parental and the subline cells die within several days, even in medium supplemented with fetal calf serum (FCS). F-36E, maintained in the presence of Epo, constitutively synthesizes hemoglobin at a significant level. F-36P, which is usually maintained in the presence of GM-CSF or IL-3, can be induced t o synthesize hemoglobin when GM-CSF or IL-3 is substituted by Epo. The surface marker profile shows that the F-36P cells are positive for the leukocyte common antigen (CD45) and some common multilineage markers such as CD13, CD33. and CD34, and negative for T- and 6-cell antigens and mature myelomonocytic antigens. However, some monoclonal antibodies recognizing erythroid and platelet glycoproteins react with these cells. Thus, this cell line has a multilineage phenotype, suggesting that the transformation event occurred in a multipotent stem cell. It is also evident that the F-36 cells can be induced t o differentiate into the erythroid lineage in the presence of Epo. This, t o our knowledge, is the first description of a human leukemic cell line that can be stimulated t o synthesize hemoglobin by Epo. 0 1991b y The American Society of Hematology. E subtype of myelodysplastic syndrome (MDS).” On October 12, 1989, approximately 5 months after the initial diagnosis, the disease progressed to overt leukemia, at which time the cells used to establish the line were obtained from the patient’s pleural fluid. At the intermediate stage of RAEB in transformation (RAEB-T), the bone marrow aspirate morphology showed some characteristics of erythroleukemia (-50% of the nucleated cells were erythroblasts, many of which were multinucleated or abnormally large in size), but did not meet the French-American-British (FAB) criteria for M6 subtype of acute myeloid leukemia. The cells were cultivated in flat-bottom 24-well plates (Becton Dickinson Labware, Lincoln Park, NJ) in a-modified Dulbecco’s medium supplemented with 20% FCS with or without G-CSF, GM-CSF, or IL-3. Morphology and cytochemistry. Light microscopy examination was performed on Wright-Giemsa-stained cytospin preparations. Cytochemical staining of myeloperoxidase (MPO), double esterase by a-naphthyl acetate and a-naphthyl butyrate, and Fe and periodic acid-Schiff (PAS) staining were performed by a standard protocol. Electron microscopy. For the standard procedure, the pellet was fixed in a 2.5% glutaraldehyde, sliced, and postfixed in 1% osmium tetroxide. Specimens were dehydrated in ethanol, embedded in Epon, and stained with uranyl acetate and lead citrate. The STABLISHMENT of several cytokine-dependent human leukemic cell lines has been described in recent years.’.’ Growth of these cell lines is usually enhanced by various hematopoietic growth factors and other cytokines. However, quite rare are the human cell lines that will die out in a few days in the presence of a sufficient amount of fetal calf serum (FCS),’ but in the absence of exogenously supplied cytokines. A previously reported erythroleukemia cell line, TF-1,’ is one example of such a truly cytokinedependent human cell line, and has proven to be an important tool for the study of hematopoiesis. Here we describe the cell line F-36, which has many morphologic, cytochemical, and biologic features in common with TF-1, including strict dependency on cytokines, but also has some distinctive biological characteristics and karyotype. In addition, successful establishment of a subline F-36E makes this cell line novel. F-36E can grow continuously in the presence of erythropoietin (Epo), but will die within several days after the depletion of Epo. Thus, this subline is expected to be useful in studies of the growth signal transduction mechanism through Epo, as well as through granulocytemacrophage colony-stimulating factor (GM-CSF) or interleukin-3 (IL-3), when used in combination with the parental line F-36P, which can be maintained by GM-CSF or IL-3, but not by Epo. Moreover, both F-36 cell lines are characterized by the inducibility of hemoglobin synthesis by Epo. Therefore, the F-36 cell lines can be used not only to analyze growth, but also to analyze hemoglobin synthesis induced by Epo. MATERIALS AND METHODS Cytokines. Recombinant human Epo6 and granulocyte colonystimulating factor (G-CSF)’ were a generous gift from KirinAmgen (Thousand Oaks, CA). Recombinant human GM-CSF8was kindly provided by Schering Plough (Osaka, Japan). Recombinant human IL-39was supplied by Kirin Brewery (Tokyo, Japan). Establishment of the cell line. We observed a male patient diagnosed with refractory anemia with excess blasts (RAEB), a Blood, Vol78, No 9 (November 1). 1991: pp 2261-2268 From the Third Department of Internal Medicine, and the Department of Pathology, Faculty of Medicine, University of Tokyo, Tokyo, Japan. Submitted May 3,1991; accepted July 3, 1991. Supported in part by a grant-in-aidfrom the Ministry of Education, Science and Culture of Japan, and a research grant for intractable diseasesfrom the Minishy of Health and Welfare of Japan. Address reprint requests to Shigem Chiba, MD, Third Depamnent of Internal Medicine, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan. The publication costs of this article were defrayed in part by page charge payment. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. section 1734 solely to indicate this fact. 0 1991 by The American Society of Hematology. 0006-4971191 I 7809-0040$3.00/0 2261 From www.bloodjournal.org by guest on November 18, 2014. For personal use only. 2262 CHIBA ET AL platelet peroxidase (PPO) was performed by the method of Breton-Gorious et al.” Cytogenetic studies. Three months before obtaining established cells, 18 mitotic figures of freshly aspirated bone marrow cells were analyzed by the trypsin-Giemsa G-banding method.” Sixteen mitotic figures of the cultured cells were analyzed by the same method 3 months after the culture was started. Surface marker study. Surface markers were detected by an immunofluorescence assay using commercial monoclonal antibodies listed in Table 1. Assay for cell proliferation. Short-term cell proliferation was examined by a colorimetric assay according to Mosmann.” Cells were incubated at a density of 1 x 104cells1100 pL in 96-well plates for various periods in RPMI 1640 medium supplemented with 10% FCS in the presence or absence of 10 nglmL GM-CSF or IL-3, or 20 U/mL of Epo at 37°C. Next, 3-(4,5-dimethylthiazo1-2-y1)-2,5diphenyltetrazolium bromide (MlT) was added at a final concentration to 0.5 mg/mL. Following a 4-hour incubation at 37T, the insoluble product was dissolved in isopropylalcohol containing 0.04N HCI. The optical density (OD) was measured at 630 nm. For dose-response plots, the assay was performed in a similar manner as described above, except that 2 x lo4 cells were initially plated and various concentrations of GM-CSF, IL-3, or Epo were added, respectively. M l T was added after 48 to 72 hours of incubation. Assay of hemoglobin synthesis. Hemoglobin synthesis was detected by benzidine staining. Time course of hemoglobin synthesis was plotted as the ratio of peak absorbances of the cytosolic protein at 414 and 280 nm. The cytosolic protein was obtained as follows. The cell pellet was washed three times with phosphate-buffered saline (PBS) without calcium and magnesium salts [PBS (-)I to remove the reddish color of the culture medium, and was resuspended in distilled water. Cells were lysed by five freeze-thaw cycles, centrifuged at 15,OOOg, and a clear supernatant was transferred. Delta-aminolevulinic acid (6-ALA) was added at 0.5 to 100 mmol/L to F-36 cells under various culture conditions. Affinity labeling of GM-CSF receptor on the cells. M n i t y labeling of GM-CSF receptor was performed using a homobifunctional chemical cross-linker, disuccinimidyl suberate (DSS). The F-36P cells were transferred to the medium and FCS alone 8 to 12 hours before the experiment. These pretreated F-36P cells, F-36E cells (1 x 10’) or U-937 cells (5 x lo6),were incubated with ’Tlabeled GM-CSF at 2 to 4 nmol/L. Binding reactions, cross-linking reactions, and analyses by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) were performed as described previously.14 Table 1. Surface Marker Profile of F-36P Cells CD 4 5 a 10 13 14 19 25 33 34 41a 42b 45 - MoAb % Positivity Leu-3a Leu-I Leu-2a J5 MY7 MY4 Leu-12 IL-2R MY9 HPCA-1 Gp2b3a Gpl b HLe-1 Glycophoirin A 2.5 0.4 0.3 2.5 99.7-99.9 0.7 0.4 0.8 92.3-97.4 25.3-60.5 53.9-96.9 0.2 95.0-97.0 25.3 Abbreviation: MoAb, monoclonal antibody. RESULTS Establishment of F-36, a parental line F-36P and a subline F-36E. Cells cultured in the presence of GM-CSF or IL-3 gradually started active proliferation, following a lag time of approximately 1 month, when most of the cells cultured in the absence of these cytokines had stopped proliferation. During the subsequent 2 months, the proliferative rate of the active cells increased, but the cells cultured in the presence of IL-3 alone stopped proliferation at the end of the third month and died thereafter. At this time, therefore, the still actively proliferating cells were all maintained in the presence of GM-CSF. We found that these cells would die within several days when transferred to the medium without any exogenously added cytokines, even if supplemented with FCS, but that they would continue to proliferate in a similar manner when GM-CSF was substituted by IL-3. This parental line was designated F-36P. When GM-CSF was substituted by Epo, the cells survived for 1to 2 weeks without active proliferation, followed by the death of most of the cells. However, after a lag time of an additional 1 month, dividing cells were apparent in one of these Epo-substituted flasks. These cells started active proliferation in the presence of Epo, but would die with the depletion of Epo. This subline was designated F-36E. The established parental and subline of the F-36 cells have been maintained in RPMI 1640 medium supplemented with 10% FCS and GM-CSF or IL-3 (for F-36P), or Epo (for F-36E), respectively. They had been cultured continuously for 18 months at the time of submission of this report. Morphology and cytochemistry. F-36P proliferates as adherent cells and as single cells in suspension. F-36E has much less tendency to adhere to the flask. Both of the F-36 cell lines have an irregular, often nonspheric shape, with spurs or blebs in suspension. Morphology of F-36P and F-36E resembled that of bizzare nonlymphoid leukemia blast (Fig 1A) or immature erythroblast (Fig lB), respectively. Cytoplasmic blebs were outstanding in all cytospin preparations. Dark nucleoli were often present. Peripheral splittings of cytoplasmic fragments were observed, some of which contained amorphous eosinophilic zones continuing from a perinuclear region (Fig 1A). Mitotic figures were observed at a frequency of up to 3% to 4%. Multinucleated cells were present at up to 1%. Cytochemical stains of MPO, or a-naphthyl and double esterase, were negative. Fe was negative in the established cell line, although it was positive on some occasions in some of the patient’s freshly aspirated bone marrow cells. Some of the established cells, as well as the patient’s aspirated bone marrow cells, showed large granular staining with PAS (Fig IC). Electron microscopic studies showed that the F-36P cells exhibited a small number of microvilli, ruffles, and elongated cytoplasmic processes of the cell surface. The cells showed a round but occasionally multilobulated nucleus without marginal chromatin and with a few large nucleoli, and a prominent cytoplasm that contained a moderate number of rough endoplasmic reticulum, mitochondria, and occasionally scattered open vesicles, and Golgi appara- From www.bloodjournal.org by guest on November 18, 2014. For personal use only. 2263 GM-CSF/IL-3- AND EPO-DEPENDENT SUBLINES tus of varying sizes (Fig 1D). The cells did not exhibit MPO. However, only a small population (1% to 2%) of cells exhibited apparent PPO (data not shown), which may correspond to the positivity of IIbIIIa antigen as described below, and thus may suggest some megakaryocytic properties of the cells. Karyotype. Chromosomal study of the freshly obtained bone marrow cells indicated the presence of normal and abnormal clones. Thirteen of 18 mitotic figures showed normal karyotype (43,XY). Four showed essentially the same karyotype: -5, -7, -9, -17, -18, 19p+, and some markers, although some additional random loss was observed in each mitotic figure. The majority of the established cells had a homogeneous karyotype (Fig 2); 43,Y (Xp+, -5, -7, -13, -16, -17, -19, -21,2q-, 9p+, 1Oq+, +4mar). Surface marker profiles. The surface marker profile of F-36P is summarized in Table 1. The results were essentially the same in F-36E subline. The cells were positive for the leukocyte common antigen (CD45) and some common multilineage markers such as CD13, CD33, and CD34, and negative for T- and B-cell antigens and mature myelomonocytic antigens. However, monoclonal antibodies recognizing glycophorin A (erythrocyte glycoprotein) or platelet glycoprotein IIbIIIa reacted with the cells. Cytokine requirements. The survival and growth of the F-36 cells are shown in Fig 3. Neither the parental or the subline cells proliferated in the absence of any cytokines, and both types of cells started to die within 36 hours despite sufficient supplementation with FCS. IL-5, IL-6, and G-CSF had no effect on the survival or growth of the cells, either alone or in combination with IL-3 or GM-CSF (data not shown). Both the parental and the subline cells proliferated dramatically with the addition of GM-CSF or IL-3 at 10 ng/mL. In F-36P, Epo (20 U/mL) prolonged the survival of the cells for up to 2 weeks, but these Epo-added cells died thereafter unless either GM-CSF or IL-3 was added. In contrast, in the F-36E subline, the proliferation of the cells could be sustained by Epo, as well as by GM-CSF or IL-3. Furthermore, observing F-36E cells for a longer period showed that Epo was the most potent cytokine among the three, because some populations of F-36E did die in the presence of GM-CSF or IL-3 alone (data not shown). Dependence of concentrations of GM-CSF, IL-3, or Epo is shown in Fig 4. Cytokine requirements for the growth of the parental line and the subline correlated well with the survival time course shown in Fig 3. Specifically, the maximal stimulation by Epo was approximately half that by GM-CSF or IL-3 for F-36P, but maximal stimulation by any of the three cytokines was almost equal to the F-36E subline in short-term assays. A colony formation study showed almost the same tendency as a characterization by the colorimetric assay; F-36P formed colonies only in the presence of GM-CSF or IL-3, but not Epo alone, and F-36E formed colonies in the presence of any of these three cytokines, although it did not in the absence of any of these (data not shown). Epo-induced hemoglobin synthesis. The F-36E cells (maintained by Epo) constitutively synthesized hemoglobin at a significant level by estimation with benzidine staining (data not shown), by peak absorbance of cytosolic protein at 414 nm (Fig 5B), and by the reddish color of the cell pellet (data not shown). The level of hemoglobin synthesis by F-36P cells (maintained by GM-CSF or IL-3) was undetectable grossly (as judged from color of the cell pellet) or colorimetrically (Fig 5A). However, after GM-CSF or I G 3 was removed and replaced by Epo, F-36P started to synthesize hemoglobin as shown by the estimation with benzidine staining, by the reddish color of the cell pellet (data not shown), and by colorimetry at 414 nm (Fig 5A). The reverse experiment, the replacement of Epo by GMCSF in F-36E subline cells, seemed to decrease cellular hemoglobin (Fig 5B), although a significant change was not observed. &ALA also induced hemoglobin synthesis in F-36P in the presence of GM-CSF or IL-3 (Fig 5A), and increased hemoglobin synthesis in F-36E maintained in Epo (Fig 5B). However, F-36P was not induced to synthesize hemoglobin by sufficient concentrations of Epo when GM-CSF or IL-3 coexisted even at a low concentrations (0.01 ng/mL). GM-CSF receptor on F-36 cells. GM-CSF receptor was identified by affinity labeling using '"I-GM-CSF. The result was similar to our previous experiments using other leukemic cell lines: two major bands composed of the a-chain and the P-chain, respectively, were labeled.'4"6 However, the ratio of the intensities of the two bands were found to be different from the cells we studied previou~ly.'~~'~ As shown in Fig 6, in the U-937 cells, the intensity of the lower molecular weight band originating from the a-chain was approximately 10-fold greater than the higher molecular weight band originating from the P-chain (lane a) when a high concentration (2 to 4 nmol/L) of '%GM-CSF was incubated, as described by us previou~ly.'~~'~ In contrast, the lower molecular weight band identified in either the parental or the subline of F-36 was much fainter in comparison to the U-937 cells (lanes e and c). Comparison of the GM-CSF receptors on F-36P and F-36E by the ligand affinity labeling showed no significant difference between these two sublines. DISCUSSION A small number of cytokine-dependent or cytokinerequiring human leukemic cell lines have been reported However, with some exceptions, most of them can be maintained even in the absence of any exogenous cytokines if enough FCS is supplemented, although various hematopoietic growth factors and other cytokines enhance their growth. It is apparent that the human hematopoietic cells are much more difficult to establish as cytokinedependent cell lines compared with the murine cells, which are easily established with dependence on various cytokines, especially IL-3. This difference has been attributed to frequent intrinsic viral integration in mouse cells or may represent the different physiologic roles of cytokines between mouse and human. The previously reported erythroleukemia cell line TF-1 is one example of such a truly cytokine-dependent human leukemic cell line. From www.bloodjournal.org by guest on November 18, 2014. For personal use only. 2264 CHIBA ET AL Fig 1. Morphology of F-36 cells (A through D). Wright-Giemsa stains of (A) F-36P and (B) F-36E. (C) PAS staining of F-36P. and (D) a transmission electron microscopic photograph of F-36P (original magnification x9.800; bar, 1 pm). From www.bloodjournal.org by guest on November 18, 2014. For personal use only. 2265 GM-CSFIIL-3- AND €PO-DEPENDENT SUBLINES Y \\ a f3gl. (Cont'd). D As judged from Wright-Giemsa and PAS stains, the F-36 cells seem to have characteristics of immature erythroid cclls. Although the host paticnt from whom F-36 was dcrivcd was initially diagnoscd with MDS by FAB classification, his discasc had many aspects of crythrolcukemia as dcscribcd in Materials and Methods. The morphological / similarity with immature erythroid cclls was not unexpcctcd. F-36 has complcx chromosomal abnormalities. Among thc karyotypic ahnormalitics of F-36, -5 and -7 arc both wcll documcntcd as an abnormality in MDS." The deletion of chromosomc 17 has hccn infrequently dcscribcd in MDS, W2. K a ~ o f F - 3 6 c f ~ l h . A m a j o r k a r y o t y p . w n 4 3 , Y ( X p-5, + , -7, -13, -16, -17, -19, -21,2q-,9p+,lOq+, +4mar). From www.bloodjournal.org by guest on November 18, 2014. For personal use only. 2266 CHIBA ET AL 0.8 FQBP (factor -) * F-36P(GM-CSF) - 0.6 P 0 ---t 0.4 F-36P(IL-3) F-36P(Epo) F56E (factor -) F-36E (OM-CSF) --*--*- 0.2 0.0 F-36E (11-3) F-36E(Epo) 0 2 4 6 8 10 Days but may be of interest since the malfunction of the p53 antioncogene located on chromosome 17q has recently been demonstrated in a number of tumors, including some leukemias." The difference of karyotype between the primary cells and the cell line could be explained as further divergence, such as additional chromosomal loss (2q-, -13, -16, -19, and -21) or duplication of chromosomes (9p+ and lo¶+). F-36 was found to have some features of a megakaryocytic lineage. Platelet glycoprotein IIbIIIa was detected and PPO was positive, although at a low level. However, the platelet glycoprotein Ib was negative, and we did not obtain any other evidence that the cells are megakaryocytic or Fig 3. Survival end proliferation of F-36P and F-36E in the presence or absence of hematopoietic growth factors. The results shown are a mean of triplicate data. Tho experiments were performed3,6, and 14 months after the primary culture with similar results. differentiate into more mature megakaryocytic cells. Further studies are necessary for detailed characterization of the lineage and differentiating potency of these cells. Successful establishment pf F-36E, a subline of F-36P, makes the F-36 cell line unique. We did not find significant biochemical differences between the two lines; GM-CSF receptors identified by affinity labeling were indistinguishable in F-36P and F-36E. However, F-36E differs from F-36P in that it can grow continuously in the presence of Epo alone. Thus, F-36E must have some mechanism that allows it to proliferate in the presence of Epo alone, an issue that can be clarified by future studies. This may be due to an alteration of Epo receptor, as was recently reported," F-36P P 0 0.4 A 1 .2 0 V." .1 1 10 2 20 200 GM, IL-3 (nglml) EPO (Ulml) F-36E , I P 0 Fig 4. Responsivenass of F-36 sublines to hematopoieticgrowth factors. The results are shown as a mean of triplicate data. B. OM, 11-3 (nglml) 0 .2 2 20 200 EPO (u/ml) From www.bloodjournal.org by guest on November 18, 2014. For personal use only. GM-CSFIIL-3- AND €PO-DEPENDENT SUBLINES - 2267 F36P (maintained with 11-3 before day 0) 5- 8 4-- X a b -w - . c d. - .e . f Epo+8AU -EPo 1L3+6AU N a 3 2 1 0 A 4 Days F36E (maintained with EPO before day 0) - + - * 0 u-937 F-36E F-36P X . -. *I Y B Fig 6. U g m d .tRnity-labellng of the GM-CSF receptors on F-36 cells. The specific bands were obwrved at 150 Kd and 90 to 100 Kd in at1 three cells liner, F-36P (lane e), F-36E (c), and U-397 (a), respectively. However, the relative intensities of these two bands were similar in F-36P and F-36E. but different in U-937. ' . l I 0 1 I I 2 3 Days 1 I 4 5 FIg 5. Hemoglobin s m h by F-36 celh. Time c o u m of the ratio of the peak absorbance at 414 nm and the absorbance ut 280 nm for cytosolic protein was plotted. Similar results were obtained by benzidine staining. or to convcrgcncc of a cellular mechanism downstrcam from thc Epo rcccptor and thc rcccpton for GM-CSF or IL-3 in F-36E. In any caw, thc cstablishmcnt of an Epo-dcpcndcnt continuous human ccll linc dcscribcd for thc first timc herc will hc an important tool for thc study of growth through Epo and its rcccptor. Thc two F-36 ccll lincs may also bc uscful in thc analysis of the relationship of growth signals mediatcd by GM-CSF, IL-3, and Epo. Only onc murinc ccll linc has previously bcen dcscrihcd that synthcsizcs hcmoglohin in rcsponsc to Epo alonc. Wc now rcport thc fint human ccll linc in which hcmoglohin synthesis is stimulatcd hy Epo alonc. Although thc diffcrcntiation potcntial of Epo has hccn provcn ahsolutcly in colony assay studics using primary bonc marrow cclls, thcrc arc only limited cxpcrimcntal systcms that use a continuous ccll linc to study thc diffcrcntiation potcntial of Epo. Thc F-36 ccll lincs can providc a uscful systcm for thc study of diffcrcntiation, as wcll as growth mcdiatcd by Epo. and are cxpcctcd to bc strong adjuncts for understanding thc cntirc signal transduction mcchanism mcdiatcd by Epo, Gltl-CSF. and IL-3. ACKNOWLEDGMENT We thank leharu Yamamki for electron microscopic studies. We also thank Tomoaki Kuwaki in Kirin Brewery for his assistance. and Arinohu Tojo. Seiji Ogawa. Yutaka Ilanazono. and Iliroaki Honda for fruitful discussion. REFERENCES I. Avanzi GC. Lista P, Giovina7zo €3. 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