Abstract
70 pts with ALL were studied with in vitro lymphocyte stimulation to PHA. Dose response curves (DRCs) and time response curves (TRCs) were performed and correlated with the % of lymphocytes (L), blasts (BL), T-cells (T) in peripheral blood and the clinical course (followup 8-175 weeks). The 48 pts with WBC < 20,000/mm3 (L>20%, BL<80%, T 29±5%) had normal DRCs and TRCs. The maximal response was achieved on day 4 (78,500±5,800 cpm). All pts had Null cell leukemia; 7/48 (14%) pts have relapsed in the marrow (BM). The remaining 22 pts with WBC>20,000/mm3 (L<20%, BL>80%, T 17.5±4%) all responded abnormally. 13/22 pts had a definite but decreased response on day 4 (18,846±5,400 cpm) with a 2- to 4-fold greater response on day 6 (WBC 100,000 ± 8,000, Z % 9.1±3, %BL 88±8, %T 7.3±3). All pts had Null cell leukemia; 4/13 (30%) have relapsed in the BM. The remaining 9 pts were unresponsive to PHA on day 4 and failed to show a delayed peak on day 6 (224,000±10,500, % L 4.3±2, %BL 93± 7, % T 39±9). 4/9 pts had T-cell leukemia; 6/9(66%) have relapsed in the BM. Three response patterns to PHA were found in pts with ALL: (a) normal (b) delayed peak indicating lymphocyte dilution by non-PHA responsive blasts and (c) flat response indicating dilution and possible immunodeficiency. A flat DRC and TRC to PHA further characterizes pts with T-cell leukemia in addition to predicting a poorer prognosis for other high WBC pts with ALL.
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Zusman, J., Kersey, J. & Nesbit, M. IMMUNOCOMPETENCE AS MEASURED BY RESPONSE TO PHYTOHE MAGGLUTININ (PHA) IN T-CELL AND NON-T-CELL ACUTE LYMPHOBLASTIC LEUKEMIA (ALL). Pediatr Res 11, 497 (1977). https://doi.org/10.1203/00006450-197704000-00762
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DOI: https://doi.org/10.1203/00006450-197704000-00762