Abstract
This study was designed to investigate the effect on the cellular immunocompetence of long-term intensive combination chemotherapy (ICC). In 28 patients with A.L.L. in continuous complete remission the PHA-induced lymphocyte blast cell proliferation (PHA-CP) and the lymphotoxin production (LT PROD) by peripheral blood lymphocytes was investigated during the initial 18 months following cessation of 2 1/2 years of ICC. PHA-CP was estimated by measuring 3H-thymidine incorporation into lymphocyte DNA during a three hour pulse on day three of culture. LT PROD was estimated by measuring (1) cell lysis (51-Cr-release) and (2) reduction of cell metabolism (DNA synthesis) in target cell cultures exposed to cell-free medium from PHA-stimulated leukocyte cultures. At the time when ICC was stopped one third of the patients showed impaired PHA-CP and two thirds showed impaired LT PROD. During the initial three months following cessation of ICC the number of patients with impaired LT PROD significantly increased. After 12 months off therapy all patients showed a normal PHA-CP while the LT PROD was still impaired in some of them.
In contrast to healthy individuals, a considerable number of the A.L.L. patients showed a dissociation between PHA-CP and LT PROD: defective LT PROD by lymphocytes with elevated proliferative capacity.
Our data suggest that upon cessation of ICC the peripheral blood of patients with A.L.L. is repopulated by lymphocytes with a normal or even elevated prol iferative capapacity but with a defective (or immature) lymphokine producing capacity. This defect of the cellular immune function in vitro may persist as long a 1 1/2 years after cessation of ICC.
This work was supported by grants from the “Kind-Philipp-Stiftung für Leuk-ämie-Forschung” and the “Deutsche Forschungsgemeinschaft (SFB 37, B7)”.
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Eife, R., Janka, G., Lau, B. et al. DISSOCIATED RECOVERY OF LYMPHOCYTE FUNCTIONS AFTER CESSATION OF LONG-TERM INTENSIVE COMBINATION CHEMOTHERAPY IN ACUTE LYMPHOBLASTIC LEUKEMIA (A.L.L.). Pediatr Res 12, 65 (1978). https://doi.org/10.1203/00006450-197801000-00031
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DOI: https://doi.org/10.1203/00006450-197801000-00031