RPMI 1640 Medium
In short
RPMI 1640 is a basal cell culture medium developed at Roswell Park Memorial Institute in 1966 for the culture of human leukocytes in suspension. It contains 2,000 mg/L glucose (11.1 mM), 2,000 mg/L sodium bicarbonate (23.8 mM) buffered for a 5% CO2 atmosphere, unusually high phosphate (about 5.6 mM), low calcium (about 0.42 mM), and a distinctive component set that includes reduced glutathione, biotin, vitamin B12, para-aminobenzoic acid and hydroxyproline. It is the standard medium for lymphocytes, hybridomas, and most suspension-adapted haematopoietic and lymphoid cell lines, normally supplemented with 10% fetal bovine serum.
What RPMI 1640 is
RPMI 1640 was developed by George Moore, Robert Gerner and H. Addison Franklin at Roswell Park Memorial Institute in Buffalo, New York, and published in 1967 in a paper on the culture of normal human leukocytes. RPMI is the institute's initials; 1640 is the formulation number in a series. It began as a modification of McCoy's 5A (itself sometimes called RPMI 1630) and was aimed squarely at a problem the Eagle-derived media handled poorly: growing lymphoblastoid cells in suspension.
That origin explains almost every distinctive feature of the medium. Suspension cells do not need — and are inhibited by — the high calcium that promotes attachment. Leukocytes cultured over days need a buffering system that holds at the CO2 levels of a standard incubator. And the medium had to support cells that were fastidious about redox state, which is why it contains reduced glutathione, a component almost unique among classical basal media.
RPMI 1640 has since proven far more general than its name suggests. It supports many adherent lines perfectly well, and it is the standard base for the NCI-60 tumour panel, for hybridoma culture, for peripheral blood mononuclear cell work, and for most human leukaemia and lymphoma lines.
RPMI 1640 composition
The standard RPMI 1640 formulation, as supplied by all major manufacturers:
Inorganic salts and bulk components
| Component | mg/L | mM |
|---|---|---|
| Sodium chloride (NaCl) | 6,000 | 102.7 |
| Sodium bicarbonate (NaHCO3) | 2,000 | 23.8 |
| D-Glucose | 2,000 | 11.1 |
| Sodium phosphate dibasic (Na2HPO4, anhydrous) | 800 | 5.6 |
| Potassium chloride (KCl) | 400 | 5.4 |
| Calcium nitrate (Ca(NO3)2·4H2O) | 100 | 0.42 |
| Magnesium sulfate (MgSO4, anhydrous) | 48.84 | 0.41 |
| Phenol red | 5 | 0.013 |
| Glutathione (reduced) | 1 | 0.003 |
| L-Glutamine (in glutamine-containing versions) | 300 | 2.05 |
Amino acids (mg/L)
L-arginine 200; L-asparagine 50; L-aspartic acid 20; L-cystine·2HCl 65; L-glutamic acid 20; glycine 10; L-histidine 15; L-hydroxyproline 20; L-isoleucine 50; L-leucine 50; L-lysine·HCl 40; L-methionine 15; L-phenylalanine 15; L-proline 20; L-serine 30; L-threonine 20; L-tryptophan 5; L-tyrosine disodium salt dihydrate 29; L-valine 20.
Vitamins (mg/L)
i-Inositol 35; choline chloride 3; para-aminobenzoic acid 1; folic acid 1; niacinamide 1; thiamine·HCl 1; D-calcium pantothenate 0.25; biotin 0.2; riboflavin 0.2; vitamin B12 (cyanocobalamin) 0.005.
Four things in this list are worth pausing on, because they are what make RPMI RPMI:
- Calcium is very low. 0.42 mM, against 1.8 mM in DMEM and MEM. This is deliberate — low calcium discourages the cell–cell and cell–substrate adhesion that would defeat suspension culture.
- Phosphate is very high. About 5.6 mM from disodium phosphate alone, roughly six times DMEM's. This gives RPMI meaningful secondary buffering capacity beyond bicarbonate and contributes to its stability in routine handling.
- Reduced glutathione is present at 1 mg/L. No other classical basal medium includes it. It contributes antioxidant capacity, which matters for primary leukocytes.
- Biotin, vitamin B12, PABA and hydroxyproline are present, none of which appear in DMEM or MEM. RPMI's vitamin coverage is broader than the Eagle-derived media even though its amino acid concentrations are much lower.
Note also what is missing: RPMI contains no iron source and no trace elements. Serum supplies these.
RPMI 1640 glucose concentration and pH
RPMI 1640 contains 2,000 mg/L D-glucose — 2.0 g/L, or 11.1 mM. This is the standard formulation figure and it is the same across suppliers, because RPMI 1640 is a defined standard formulation rather than a proprietary one. If you are cross-checking a datasheet from any manufacturer against a protocol written for another, the glucose is 2.0 g/L in all of them unless the product name says otherwise.
The exceptions are explicitly labelled variants:
- ATCC-modified RPMI 1640 raises glucose to 4,500 mg/L (4.5 g/L, 25 mM) and adds 1 mM sodium pyruvate and 10 mM HEPES.
- Glucose-free RPMI 1640 contains none, and is used for metabolic work where you set the carbon source yourself.
- RPMI 1640 with HEPES keeps glucose at 2.0 g/L and adds the buffer.
At 11.1 mM, RPMI's glucose is close to physiological blood glucose and roughly half that of high-glucose DMEM. This is a genuine advantage for metabolic and immunometabolism work, where 25 mM glucose is a pharmacological concentration that suppresses oxidative phosphorylation in many cell types. It is a disadvantage for very dense cultures, which exhaust it sooner and need feeding more often.
The working pH of RPMI 1640 is 7.2 ± 0.2, measured on complete medium equilibrated in 5% CO2. As with any bicarbonate-buffered medium, a bottle measured cold on the bench reads higher because it has lost dissolved CO2, and returns to specification in the incubator. RPMI's high phosphate content gives it more CO2-independent buffering than DMEM, so it drifts more slowly during handling.
RPMI vs DMEM: the difference between RPMI and DMEM
These are the two most-used basal media and they are not interchangeable. The headline differences are calcium, phosphate, glucose, amino acid concentration and bicarbonate — the comparison table at the foot of this page gives the full component-level view with the practical consequence of each difference.
The practical decision usually comes down to three questions.
Is the culture in suspension or attached? Suspension lymphoid and haematopoietic cells go in RPMI. Firmly adherent fibroblast and epithelial lines go in DMEM. RPMI's low calcium works against strong attachment; DMEM's 1.8 mM calcium supports it.
What does the line's published protocol say? For established lines this is not a matter of preference. Jurkat, K562, THP-1, Raji, U937, HL-60, MOLT-4, most NCI-60 panel members and most hybridomas have RPMI 1640 in their reference protocols. HEK293, HeLa, NIH/3T3, Vero, COS-7 and C2C12 have DMEM. Switching a line between them changes doubling time, saturation density and often protein expression, so it invalidates comparison with the literature unless you re-characterise.
What is the metabolic demand? DMEM at 25 mM glucose and roughly four times RPMI's amino acid concentration is built for dense, fast, high-demand cultures. RPMI at 11 mM glucose and modest amino acid levels is built for cells that grow at moderate rates in suspension over days. Pushing a high-demand culture in RPMI means feeding it more often.
One genuinely useful hybrid exists: the ATCC-modified RPMI 1640, which raises glucose to 4.5 g/L and adds 1 mM sodium pyruvate and 10 mM HEPES. It keeps RPMI's ionic character while giving the nutrient reservoir of a high-glucose medium, and is a good option for hybridomas and other cultures that are RPMI-dependent but grow to high density.
Which cells RPMI 1640 suits
Established lymphoid and haematopoietic lines. Jurkat, K562, HL-60, THP-1, U937, Raji, Ramos, MOLT-4, Daudi, and most B- and T-lymphoblastoid lines. Standard supplementation is 10% FBS and 2 mM L-glutamine.
Primary human leukocytes. PBMC, isolated T cells, B cells, monocytes and dendritic cell cultures. RPMI's original design case. For long primary cultures, RPMI's glutathione content and broad vitamin coverage are meaningful advantages.
Hybridomas and antibody production. RPMI 1640, often with additional supplements, is the classical hybridoma base. Chemically defined hybridoma media are now the norm for production, but RPMI remains the standard for fusion and cloning.
Many adherent tumour lines. MCF-7, A549, PC-3, HT-29, SK-MEL and a great many others are routinely maintained in RPMI. There is no rule that RPMI is only for suspension cells; the NCI-60 panel is grown in RPMI across both adherent and suspension members.
Where RPMI is a poor choice: cells that need high calcium for junction formation or differentiation, very high-density fed-batch processes without a modified formulation, and clonal growth at low density without serum, which requires an F-12-derived or purpose-designed base.
Buffering, CO2 and HEPES variants
RPMI 1640's 2,000 mg/L (23.8 mM) sodium bicarbonate is matched to a 5% CO2 atmosphere, which is what almost every incubator is set to. This is one of RPMI's quiet practical advantages over DMEM, whose 3,700 mg/L bicarbonate was formulated for 10% CO2 and therefore sits alkaline at 5%.
RPMI's high phosphate also gives it a secondary buffer that operates independently of CO2, so the medium tolerates time on the bench better than a low-phosphate medium of the same bicarbonate level. It still loses CO2 and drifts alkaline if left open, so keep bottle-open time short.
HEPES variants are supplied at 25 mM (or 10 mM in the ATCC modification). Use them for flow cytometry, live-cell imaging, extended sorting runs, or any protocol that keeps cells out of a CO2 atmosphere for more than a few minutes. Two caveats apply: HEPES generates hydrogen peroxide under light exposure, and at 25 mM it is toxic to some primary cells. Do not treat it as a free upgrade.
Phenol-red-free RPMI is available for fluorescence and absorbance assays, for flow cytometry where phenol red raises background, and for hormone-response work — phenol red has weak oestrogenic activity, which is a documented confounder in oestrogen receptor-positive lines such as MCF-7.
Supplementation and modifications
Serum. 10% FBS is standard; some protocols use 20% for primary or low-density cultures, and 5% for well-adapted lines.
Glutamine. RPMI contains 300 mg/L (about 2 mM) when supplied glutamine-containing. Because glutamine degrades in solution to ammonia, glutamine-free RPMI plus fresh addition at use — or the stable dipeptide L-alanyl-L-glutamine — gives more consistent results, particularly for cultures fed weekly rather than every two days.
2-Mercaptoethanol. 50 µM is standard for primary lymphocyte, hybridoma and mouse T cell culture. It supports cystine uptake and helps maintain intracellular glutathione. This is a genuine requirement for some primary cultures, not an optional extra.
Sodium pyruvate and non-essential amino acids. 1 mM pyruvate and 1x NEAA are common additions, particularly for the NCI-60 protocols and for cultures at reduced serum. RPMI already contains several non-essential amino acids, so NEAA supplementation adds less here than it does to DMEM.
Glucose-free RPMI is used for metabolic work — substituting galactose to force oxidative metabolism, or titrating glucose to a defined level. RPMI is a better base than DMEM for this because its baseline glucose is closer to physiological to begin with.
Powdered RPMI is the economical route at scale. It is supplied without sodium bicarbonate, which is added at reconstitution (2.0 g/L), the pH adjusted about 0.1–0.2 units below target to allow for the rise during filtration, and the solution sterile-filtered at 0.22 µm.
Storage, stability and handling
Liquid RPMI 1640 is stored at 2–8 °C protected from light, with a typical unopened shelf life of 12–24 months. Once glutamine has been added, plan on about four weeks of working life; serum-supplemented medium, two to four weeks.
Light exposure is the most underestimated storage problem. Riboflavin, folic acid and tryptophan photodegrade, and where HEPES is present the reaction generates hydrogen peroxide. Medium stored on an open shelf under laboratory lighting measurably loses plating efficiency. Keep bottles in a closed refrigerator, not a lit display fridge, and do not leave working aliquots on the bench between uses.
Warm only what you need. Repeatedly bringing a full 500 mL bottle to 37 °C accelerates glutamine hydrolysis and drives off bicarbonate. Room temperature is adequate for most feeding.
A faint pink deepening toward magenta after a bottle has been open is normal bicarbonate loss and reverses in the incubator. Cloudiness, particulates or a shift to yellow in an uninoculated bottle are not normal — discard, and check your filtration or aseptic technique rather than the medium.
Common mistakes
Assuming RPMI is only for suspension cells. A large fraction of adherent tumour lines are maintained in it routinely.
Switching a line from DMEM to RPMI (or back) mid-project. Growth rate, saturation density, and expression of some genes change. If you must switch, adapt gradually over several passages and re-baseline your assays.
Forgetting 2-mercaptoethanol for primary lymphocyte or hybridoma culture. Its absence is a common reason primary T cell cultures underperform.
Using RPMI for cells that need calcium. At 0.42 mM, RPMI will not support the junction formation or calcium-driven differentiation that some epithelial protocols depend on.
Treating the ATCC modification as plain RPMI. It differs in glucose (4.5 versus 2.0 g/L), pyruvate and HEPES. Record which one you used.
Adding glutamine and not dating the bottle. Ammonia from glutamine decay accumulates and is toxic to lymphoid cells at lower concentrations than many adherent lines tolerate.
| Property | RPMI 1640 | DMEM (high glucose) | Practical consequence |
|---|---|---|---|
| D-Glucose | 2,000 mg/L (11.1 mM) | 4,500 mg/L (25 mM) | DMEM sustains denser cultures for longer; RPMI is closer to physiological |
| Sodium bicarbonate | 2,000 mg/L (23.8 mM) | 3,700 mg/L (44.0 mM) | RPMI is matched to 5% CO2; DMEM was formulated for 10% CO2 |
| Calcium | 0.42 mM (as calcium nitrate) | 1.8 mM (as calcium chloride) | DMEM favours attachment and junctions; RPMI favours suspension growth |
| Phosphate | ~5.6 mM (Na2HPO4) | ~0.9 mM (NaH2PO4) | RPMI has substantial CO2-independent secondary buffering |
| Amino acid concentration | Modest; 19 amino acids incl. hydroxyproline | ~4x Eagle's MEM; no NEAA beyond glycine and serine | DMEM supports higher biomass per feed; RPMI covers a broader amino acid set |
| Reduced glutathione | 1 mg/L | Absent | RPMI carries some antioxidant capacity useful for primary leukocytes |
| Biotin / vitamin B12 / PABA | Present (0.2 / 0.005 / 1 mg/L) | Absent | RPMI's vitamin coverage is broader despite lower amino acids |
| Iron and trace elements | None | Ferric nitrate 0.1 mg/L only | Both depend on serum or a defined supplement |
| Phenol red | 5 mg/L | 15 mg/L | Lower assay background in RPMI |
| Typical cells | Jurkat, K562, THP-1, HL-60, Raji, PBMC, hybridomas, NCI-60 panel | HEK293, HeLa, NIH/3T3, Vero, COS-7, C2C12, primary fibroblasts | Follow the line's reference protocol rather than lab habit |
Frequently asked questions
What is RPMI 1640 medium used for?
RPMI 1640 is the standard basal medium for lymphoid and haematopoietic cells — peripheral blood mononuclear cells, T and B cells, and lines such as Jurkat, K562, THP-1, HL-60 and Raji — as well as hybridomas and a large number of adherent tumour lines including the NCI-60 panel. It is normally supplemented with 10% fetal bovine serum and 2 mM L-glutamine.
What does RPMI stand for?
RPMI stands for Roswell Park Memorial Institute, the Buffalo, New York cancer centre where the medium was developed by George Moore and colleagues and published in 1967. The 1640 is the formulation number within a numbered series; RPMI 1630 was an earlier formulation in the same series.
What is the glucose concentration in RPMI 1640?
RPMI 1640 contains 2,000 mg/L D-glucose — 2.0 g/L, or 11.1 mM. This is the standard formulation figure and is identical across suppliers, since RPMI 1640 is a published standard rather than a proprietary formulation. The labelled exceptions are ATCC-modified RPMI at 4,500 mg/L and glucose-free RPMI, which contains none.
What is the pH of RPMI 1640?
RPMI 1640 works at pH 7.2 ± 0.2, measured on complete medium equilibrated in a 5% CO2 atmosphere. Measured cold on the bench it reads higher because dissolved CO2 has escaped, and it returns to specification in the incubator. RPMI's high phosphate content gives it more CO2-independent buffering than DMEM, so it drifts more slowly during handling.
What is the difference between RPMI and DMEM?
RPMI has less glucose (2.0 versus 4.5 g/L), much less calcium (0.42 versus 1.8 mM), far more phosphate (about 5.6 versus 0.9 mM), less bicarbonate (2.0 versus 3.7 g/L, so it matches 5% CO2 rather than 10%), and lower amino acid concentrations. RPMI also contains reduced glutathione, biotin, vitamin B12 and PABA, which DMEM lacks. RPMI suits suspension lymphoid cells; DMEM suits dense adherent cultures.
Can I use RPMI 1640 for adherent cells?
Yes. Many adherent tumour lines — MCF-7, A549, PC-3, HT-29 and most of the NCI-60 panel — are routinely maintained in RPMI. The caveat is its low calcium (0.42 mM), which means cells that depend on calcium for junction formation or differentiation, including some keratinocyte and epithelial protocols, will not behave normally in it.
What CO2 concentration does RPMI 1640 need?
5% CO2. RPMI's 2,000 mg/L sodium bicarbonate is formulated for a 5% atmosphere, which is the standard incubator setting. This is one reason RPMI holds pH more predictably in a typical laboratory than DMEM, whose higher bicarbonate was designed for 10% CO2.
Why does RPMI 1640 contain glutathione?
Reduced glutathione at 1 mg/L provides antioxidant capacity, which supports primary leukocytes over multi-day culture. RPMI is essentially the only classical basal medium to include it, and it reflects the medium's original purpose of growing normal human white blood cells rather than robust transformed lines.
Do I need to add L-glutamine to RPMI 1640?
Only if you bought a glutamine-free formulation. Glutamine-containing RPMI has 300 mg/L (about 2 mM). Because glutamine degrades in solution to ammonia, many laboratories deliberately buy glutamine-free medium and add fresh glutamine at use, or use the stable dipeptide L-alanyl-L-glutamine instead.
Should I add 2-mercaptoethanol to RPMI?
For primary lymphocyte culture, mouse T cells and hybridoma work, yes — 50 µM is standard. It supports cystine uptake and helps maintain intracellular glutathione. For established robust lines such as Jurkat or K562 it is usually unnecessary. Its omission is a common reason primary lymphocyte cultures underperform.
What is ATCC-modified RPMI 1640?
It is RPMI 1640 with glucose raised to 4.5 g/L, 1 mM sodium pyruvate added and 10 mM HEPES added. It keeps RPMI's low-calcium, high-phosphate character while providing the nutrient reservoir of a high-glucose medium, which suits hybridomas and other RPMI-dependent cultures grown to high density. Record which version you used — it is not equivalent to standard RPMI.
How long does RPMI 1640 last?
Unopened liquid RPMI typically has a 12–24 month shelf life at 2–8 °C in the dark. After glutamine is added, plan on about four weeks; serum-supplemented medium, two to four weeks. Light is the main enemy — riboflavin, folic acid and tryptophan photodegrade, and HEPES-containing medium generates hydrogen peroxide under light.
Is RPMI 1640 serum-free?
No. RPMI is a basal medium with no protein, lipid, growth factor or trace element package, and no iron source at all. It requires 10% fetal bovine serum or a defined supplement providing transferrin or another iron source, insulin, selenium and lipids.
Why is my RPMI turning yellow so fast?
Yellow means acidification below about pH 6.8. In RPMI the usual causes are a culture that has outgrown its feeding interval, seeding density set too high for the medium's 11 mM glucose, a CO2 supply problem, or contamination. Because RPMI carries less glucose than DMEM, dense cultures exhaust it sooner — either feed more often or move to a modified high-glucose RPMI.
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Related reference pages
- DMEM (Dulbecco's Modified Eagle Medium) DMEM (Dulbecco's Modified Eagle Medium) is a basal cell culture medium derived from Eagle's Minimal Essential Medium by raising the amino acid and vitamin concentrations roughly fourfold. It is supplied in high-glucose (4,500 mg/L, 25 mM) and low-glucose (1,000 mg/L, 5.6 mM) forms, buffered with 3,700 mg/L sodium bicarbonate, and requires serum or a defined supplement plus a CO2 atmosphere to hold physiological pH. DMEM is the default medium for adherent lines such as HEK293, HeLa, NIH/3T3, Vero and CHO-derived adherent cultures, and for most primary fibroblasts.
- MEM Alpha (α-MEM) and Minimum Essential Medium MEM alpha (α-MEM) is Eagle's Minimum Essential Medium enriched with all the non-essential amino acids, sodium pyruvate, lipoic acid, ascorbic acid, biotin and vitamin B12, and is supplied either with or without ribonucleosides and deoxyribonucleosides. It uses the same salt base as MEM — 2,200 mg/L sodium bicarbonate matched to a 5% CO2 atmosphere, 1,000 mg/L glucose and 1.8 mM calcium — and is the standard medium for mesenchymal stromal cells, bone marrow cultures, osteoblasts, CHO-DXB11 and CHO-DG44 selection, and many primary cell types. The nucleoside-free version is required for HAT and methotrexate-based selection systems.
- Chemically Defined Medium A chemically defined medium is a cell culture medium in which the identity and concentration of every component is known — no serum, no protein hydrolysates, no undefined extracts. It may still contain proteins, provided they are recombinant and of known sequence and concentration, which is why chemically defined and protein-free are distinct categories rather than synonyms. Chemically defined media eliminate the lot-to-lot variability, adventitious agent risk and regulatory burden of serum, and are the standard for biopharmaceutical production in CHO, HEK293 and hybridoma systems.
- HBSS (Hank's Balanced Salt Solution) HBSS (Hank's Balanced Salt Solution) is an isotonic balanced salt solution used to wash cells, transport tissue, dilute reagents and hold cells briefly outside their growth medium. It contains 8.0 g/L sodium chloride, 1.0 g/L D-glucose, phosphate and 350 mg/L sodium bicarbonate, and is supplied either with calcium and magnesium (1.26 mM Ca, ~0.9 mM Mg total) or without them. Its low bicarbonate means it is designed for use at atmospheric CO2 or in sealed vessels, not for prolonged culture in a 5% CO2 incubator.
- EMEM vs DMEM: What the Modification Actually Changed EMEM (Eagle's Minimum Essential Medium, also sold as MEM) and DMEM (Dulbecco's Modified Eagle Medium) are the same medium one generation apart: DMEM is Eagle's formulation enriched, with roughly four times the vitamins, about twice most amino acids, twice the glutamine, added glycine and serine, ferric nitrate, and 3.7 g/L sodium bicarbonate against EMEM's 1.5-2.2 g/L. The practical consequence is that DMEM supports fast-growing, metabolically demanding lines such as HEK293 and NIH/3T3, while EMEM suits slower, less demanding adherent cells and primary lines - and because DMEM's higher bicarbonate is formulated for 10% CO2 while EMEM's suits 5%, the two are not interchangeable without checking your incubator.
- PBS vs DPBS: What Is Different, and Which One to Use PBS and DPBS are both phosphate-buffered saline solutions; the difference is the recipe, not the function. Dulbecco's formulation (DPBS) adds potassium chloride and carries roughly twice the phosphate of a typical PBS (about 9.5 mM versus about 4 mM), and it is sold in two versions - with calcium and magnesium, and without. In practice the with-or-without-divalent-cations choice matters far more than the PBS-or-DPBS label: use a calcium- and magnesium-free solution to wash cells before trypsinisation or EDTA dissociation, because Ca2+ and Mg2+ support the cadherin and integrin bonds you are about to break, and use the version containing calcium and magnesium when cells must stay attached and intact through the wash.
- Glucose solution in cell culture A cell culture glucose solution is a concentrated sterile D-glucose stock, commonly supplied at 300-450 g/L (30-45% w/v), used to supplement basal media and to feed cultures that consume glucose faster than the medium supplies it. D-glucose has a molecular weight of 180.16, so 1 g/L equals 5.55 mM: standard media run from 1 g/L (5.5 mM) in low-glucose DMEM through 2 g/L (11.1 mM) in RPMI 1640 to 4.5 g/L (25 mM) in high-glucose DMEM. Glucose is added to prevent depletion in long or high-density cultures, and it is normally sterile-filtered rather than autoclaved, because heating glucose with amino acids produces browning reaction products.
Sources
- Moore GE, Gerner RE, Franklin HA. Culture of normal human leukocytes. JAMA. 1967;199(8):519-524.
- Thermo Fisher Scientific — RPMI 1640 (11875) formulation
- AAT Bioquest — RPMI 1640 Medium formulation and recipe
- Eagle H. Amino acid metabolism in mammalian cell cultures. Science. 1959;130(3373):432-437.
- Yao T, Asayama Y. Animal-cell culture media: history, characteristics, and current issues. Reprod Med Biol. 2017;16(2):99-117.
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