[Therapeutic procedure in chronic lymphadenosis (CLL)].
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The distribution of T-lymphocyte subsets of 18 patients with lymphocytic leukaemia tested with monoclonal antibodies as well as E-rosettes formations and EAC-rosettes formations were studied. The patients classified according to RAI (stages 0-II. and III-IV.) a proportional decrease of T-lymphocytes was observed only, whereas their absolute number increased. T-lymphocyte subsets also changed: the ratio of CD4 positive lymphocytes reduce, while the proportion of CD-8 positive lymphocytes increased. The ratio of the two cell groups was below the normal value (1.8 and 1.0, respectively). This value is lower in stages III-IV., and refers to a serious immune imbalance, the latter being responsible for acute infections. The four weeks medication with Leukeran and COP resulted in unchanged rates of pathological cells with a decrease in the number of lymphocytes. These phenomena primarily refer to clonal damage of the cell line, resulting in pathological T-helper and T-suppressor functions. Owing to the relatively long lifespan of the lymphocytes, only a prolonged cytostatic treatment can yield favorable results in therapy.
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In a group of 9 patients with chronic lymphocytic or lymphoplasmocytic leukaemia in clinical stage from 2 to 4 (classification of Rai et al.) 8 various CHOP programmes (cyclophosphamide, hydroxyldaunomycin, oncovin, prednisone) were used. In 6 cases (67%) partial remission was obtained, with normalization of peripheral blood and bone marrow patterns, with statistically significant decrease of the proportion of cells forming rosettes with murine erythrocytes, and with reduction or full normalization of the size of previously enlarged lymph nodes. In one case the control examination of a lymph node failed to demonstrate the previously present clone of cells with chromosomal aberration, although in histological examination the diagnosis of lymphoplasmocytic lymphoma was maintained. In the remaining 3 cases no partial remission was noted, and in one case progression was recognized. We think similarly as the French haematologists studying chronic lymphatic leukaemia, that the CHOP programme is effective in the treatment of chronic lymphatic or lymphoplasmocytic leukaemia.
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