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Studies in chronic lymphocytic leukaemia II. Lymphocyte markers, cellular and humoral immunity and the effect of treatment.

Observations were made on 15 patients with chronic lymphocytic leukaemia, 3 with non-Hodgkin's lymphoma, and 18 healthy controls. These include characterization of lymphocytes, assessment of humoral and cell-mediated immunity and the effect of treatment. Those responding to therapy showed a disappearance of 'null' lymphocytes from the blood with improvement in clinical and haematological parameters. Their immune capacity, however, remained unchanged or continued to deteriorate.

Adult↗

Mitogenicity of fetal calf serum.

The mitogenic effect of fetal calf serum (FCS) has been studied. Human lymphocytes, especially cord blood cells, undergo blastogenesis in media supplemented with FCS. The mitogenic effect is exerted on non-T (B and null) lymphocytes, but not on T cells. Bovine serum albumin (BSA) successfully substitutes for FCS in mitogen-induced lymphocyte blastogenesis. Unlike FCS, it has no mitogenic properties.

Animals↗

Subfractionation of human peripheral blood lymphocytes by partitioning in two-polymer aqueous phase systems. Characteristics of a small subpopulation of cells with high partition coefficient.

Mixtures of aqueous solutions of dextran and poly(ethylene glycol) form immiscible 2-phase systems that are suitable for the separation of viable, functionally-competent cells on the basis of their surface properties. With the appropriate choice of ionic composition, these systems will separate cells on the basis of charge-related surface characteristics. We have previously shown that in charge-sensitive phase systems, human B lymphocytes have a low partition coefficient (K) and T cells have an intermediate K. The cell subpopulation with the highest K values contains large null lymphocytes that have most of the antibody-dependent and natural killer activities. The present study further characterizes this latter cell subpopulation. 8-33% of peripheral blood lymphocytes in normal persons had high K values. About 50% of these cells had typical Giemsa-staining granules characteristic of killer cells and one third had Fc receptors, but lacked complement receptors. Although 15-30% of the cells with high K values formed rosettes with sheep erythrocytes, there was virtually no response to T-cell mitogens such as PHA and Con A. Mixing cells having high K values with mitogen-responsive T cells from intermediate cell fractions revealed no evidence of suppressor-cell activity to explain the poor mitogen response. The studies indicate that a heterogeneous population of cells share charge-related surface properties resulting in a high partition coefficient. These cells comprise a significant proportion of human peripheral blood lymphocytes and include virtually all of the large granular lymphocytes as well as a large population without this morphology that shares the feature of unresponsiveness to T-cell mitogens.

Antibody-Dependent Cell Cytotoxicity↗

A novel lymphocyte differentiating factor in serum of patients with mycosis fungoides and Sezary syndrome.

Sera from 13 patients with mycosis fungoides and 2 with Sezary syndrome were tested for activity that induces lymphocyte differentiation. Induction of Thy-1.2 antigen and surface immunoglobulin were used, respectively, to measure T- and B-cell differentiation. The indicator cells were null lymphocytes from the spleens of congenitally athymic nude mice. Normal serum induced some T-cell but no B-cell differentiation. The T-cell-inducing activity was ascribed to thymic hormone and declined with advancing age. A totally different pattern emerged with patient serum. T-cell-inducing activity was significantly more active than in normal serum (p less than 0.001). This activity did not decline with advancing age and was not inhibited by a concentration of ubiquitin, which blocks nonspecific beta-adrenergic induction. B-cell-inducing activity was also present. This novel serum factor (or factors) is a potent inducer of T- and B-lymphocyte differentiation and is associated with neoplastic lymphoproliferation of the T-cell series.

Adult↗

Null cell chronic lymphocytic leukaemia.

Lymphocytes lacking receptors for sheep erythrocytes and surface immunoglobulin were present in the blood in large numbers at some stage in four cases of chronic lymphocytic leukaemia (which included a mother and son), and formed a substantial proportion of the circulating lymphocytes in other cases. These null cells possessed receptors for mouse erythrocytes. Other B-cell markers were also found on these cells. Serial studies showed a great variation in the number of null cells during the course of the disease (which may be associated with treatment), suggesting variation in the the maturation of leukaemic cells, and indicating that the surface marker complement may not reflect the constitution of the cell undergoing the original malignant change.

Aged↗

Depressed cell-mediated immunity in iron-deficiency anemia due to chronic loss of blood.

Twelve women with iron-deficiency anemia due to chronic loss of blood, but free from any other pathology that might alter the immune response, were studied. The patients were tested for cell immunity both in vitro, by B and T lymphocyte quantitation and by blastic transformation of the lymphocytes with phytohemagglutinin (PHA), and in vivo, by dinitrochlorobenzene (DNCB), tuberculin, trychophytine and varidase skin tests. The same tests were repeated after iron therapy and also applied to a group of 12 normal control subjects. The percent of T lymphocytes increased significantly from 55.1 to 66.0% after treatment, while the absolute values did not change. There was a significant decrease in both the number and percent of "null" lymphocytes after treatment. The percent and absolute number of B lymphocytes did not change after treatment. Blastic transformation indices were within the normal range both before and after treatment. Seven women who were DNBC-negative before treatment became DNBC-positive after iron therapy. Of the 5 patients who were tuberculin-negative before treatment, 2 became positive after iron therapy. Reactivity to trychophytine was observed in 3 patients before treatment as compared to 5 afterwards. Reactivity to varidase increased from 4 to 6 patients upon iron therapy. On the basis of changes in immunological reactivity observed after iron replenishment, we conclude that iron deficiency is an important factor in the genesis of the immunological alterations occurring in iron-deficiency anemia.

Anemia, Hypochromic↗

Hu Ly-M3--a human leukocyte antigen.

A monoclonal antibody, 5-4.8, was produced against human peripheral blood lymphocytes and it appears to be leukocyte-specific in that it reacts with a common determinant (called Hu Ly-m3) present on the peripheral blood T, B and null lymphocytes of 40 individuals. The antibody also reacts with thymocytes, spleen cells, and bone marrow cells (30%) and weakly with granulocytes and platelets--but not with heart, liver, or kidney. Affinity to lentil-lectin and molecular weight analysis demonstrated that Hu Ly-m3 is a glycoprotein consisting of a single chain of 47,000 daltons which is not HLA because it is not present on all cells; because it is present on the surface of the phenotypically HLA- Daudi cell line; and because soluble HLA antigens did not inhibit the binding of the 5-4.8 antibody.

Animals↗

Subpopulation of peripheral blood lymphocytes in human encephalitis caused by group B arboviruses (Dengue, West Nile and Japanese B encephalitis.

Sera from twenty patients with clinically diagnosed viral encephalitis were studied during the acute and convalescent phases of illness for evidence of group B arboviral infection by demonstrating a rise in the titre of haemagglutination inhibiting (HI) antibodies. The immune status of these individuals was studied by quantitating peripheral T, T and 'null' lymphocytes. The percentage of total T cells in arboviral encephalitic (AE) group decreased significantly while that of B cells and 'active' T cells remained unaltered when compared to that of normal individuals. The null cell percentage, on the other hand increased significantly in the AE group. The absolute number of circulating T and B cells did not alter in the AE group while that of null cells rose significantly. The percentage and concentration of T. B and null cells during the convalescent phase of AE did not differ significantly when compared to those of the acute phase.

Acute Disease↗

Alkaline phosphatase in human lymphocyte subpopulations.

The levels of membrane alkaline phosphatase have been measured on different lymphocyte fractions from human peripheral blood separated on bovine serum albumin discontinuous gradients. The peak in enzyme activity was observed in a non-T-, non-B-cell fraction, rich in "null" lymphocytes; the lowest values were found in the fraction with the highest proportion of T-cells.

Alkaline Phosphatase↗

T and B lymphocytes in the aqueous humor of patients with uveitis.

Sixteen patients with different types of uveitis (ocular toxoplasmosis, chronic cyclitis, Vogt-Koyanagi-Harada syndrome, Behçet's syndrome, ocular herpes, and a probable nematode) had the aqueous humor withdrawn and had the number of T, B, and null lymphocytes assessed. T and B lymphocytes were identified by rosette formation with sheep erythrocytes and with human erythrocytes sensitized with IgM antibody and complement or zymosan-C3 complexes, respectively. A much higher number of T lymphocytes than B lymphocytes was observed in all cases. The results were not influenced by treatment with steroids or immunosuppressive drugs for local, periocular, or systemic effects.

Aqueous Humor↗

Identification of a C3bi-specific membrane complement receptor that is expressed on lymphocytes, monocytes, neutrophils, and erythrocytes.

Cells expressing a membrane C receptor (CR(3)) specific for C3b-inactivator- cleaved C3b (C3bi) were identified by rosette assay with C3bi-coated sheep erythrocytes (EC3bi) or C3bi-coated fluorescent microspheres (C3bi-ms). C3bi- ms, probably because of their smaller size, bound to a higher proportion of cells than did EC3bi. C3bi-ms bound to greater than 90 percent of mature neutrophils, 85 percent of monocytes, 92 percent of erythrocytes, and 12 percent of peripheral blood lymphocytes. Binding of C3bi-ms to neutrophils, monocytes, and erythrocytes was inhibited by fluid-phase C3bi, Fab anti-C3c, or Fab anti-C3d but was not inhibited by F(ab')(2) anti-CR(1) (C3b receptor) or F(ab')(2) anti-CR(2) (C3d receptor) nor by fluid-phase C3b, C3c, or C3d. This indicated that monocytes, neutrophils, and erythrocytes expressed C3bi receptors (CR(3)) that were separate and distinct from CR(1) and CR(2) and specific for a site in the C3 molecule that was only exposed subsequently to cleavage of C3b by C3b inactivator and that was either destroyed, covered, or liberated by cleavage of C3bi into C3c and C3d fragments. Lymphocytes differed from these other cell types in that they expressed CR2 in addition to CRa. Lymphocyte C3bi-ms rosettes were inhibited from 50 to 84 percent by F(ab')(2)-anti-CR(2) or fluid-phase C3d, whereas C3d-ms rosettes were inhibited completely by F(ab')(2) anti-CR(2), fluid-phase C3bi, or fluid- phase C3d. Thus, with lymphocytes, C3bi was bound to CR(3), and in addition was bound to CR(2) by way of the intact d region of the C3bi molecule. In studies of the acquisition of C receptors occurring during myeloid cell maturation, the ability to rosette with C3bi-coated particles was detected readily with immature low-density cells, whereas this ability was nearly undetectable with high density mature polymorphonuclear cells. This absence of C3bi binding to polymorphs was not due to a loss of the CR(3) but instead was due to the maturation-linked acquisition of the abiity to secrete elastase that cleaved reagent particle-bound C3bi into CR(3)-unreactive C3d. Neither neutrophils nor monocytes bound C3d-coated particles at any stage of maturation. Assay of CR(3) with mature neutrophils required inhibition of neutrophil elastase with either soybean trypsin inhibitor or anti-elastase antibodies, and the amounts of these elastase inhibitors required to allow EC3bi rosette formation increased with neutrophil maturation. Because lymphocytes bound C3bi to CR(2) as well as to CR(3), specific assay of lymphocyte CR(3) required saturation of membrane CR(2) with Fab' anti-CR(2) before assay for rosettes with C3bi-ms. Only 3.5 percent of anti-CR(2)- treated peripheral blood lymphocytes bound C3bi-ms. Therefore, among normal blood lymphocytes the majority of the 12 percent C3bi-ms-binding cells expressed only CR(2) (8.5 percent), and the small proportion of C3bi-ms- binding cells that expressed CR(3) (3.5 percent) represented a distinct subset from the CR2(+) cells. Double-label assay indicated that 3.0 percent out of 3.5 percent of these CR(3)-bearing lymphocytes were B cells because they expressed membrane immunoglobulins. Of the remaining CR(3)(+) cells, 0.2 percent expressed either Leu-1 or 3A1 T cell antigens, and 0.6 percent expressed the OKM-1 monocyte-null lymphocyte determinant.

Cell Membrane↗

A unique antigen expressed on myeloid cells and acute leukemia blast cells defined by a monoclonal antibody.

A murine hybridoma-derived monoclonal antibody, PM-81, was obtained from a fusion of cells of the NS-1 myeloma cell line with cells from a mouse immunized with the HL-60 promyelocytic leukemia cell line. This cytotoxic IgM monoclonal antibody was specific for myeloid cells. Employing indirect immunofluorescence and flow cytometry, we determined that this antibody reacts strongly with normal human granulocytes, eosinophils, and monocytes but not lymphocytes (including phytohemagglutinin-activated lymphocytes), null cells, red blood cells, or platelets. Moreover, the PM-81 antibody reacts with leukemia cells from 19 of 22 patients with acute myelocytic leukemia of all FAB subclasses, three of three patients with common acute lymphocytic leukemia, four of four patients with chronic myelocytic leukemia (CML) in myeloid blast crisis (terminal transferase (TdT)-negative) but did not react with cells from two patients with CML in lymphoid blast crisis (TdT-positive) or five patients with chronic lymphocytic leukemia. The myeloid cell lines HL-60, K562, KG-1, and U937 were all reactive with PM-81. The lymphoid lines CCRF-CEM and Daudi did not express PM-81 but HSB-2 was positive. The PM-81 antigen was absent on myeloid and erythroid progenitor cells as determined by their insusceptibility to complement-dependent lysis. In addition, only PM-81-unreactive cells were capable of colony formation. Furthermore, the PM-81 antibody does not appear to induce modulation of the antigen to which it binds. Thus, this monoclonal antibody appears to fulfill several criteria for clinical utility in the diagnosis and treatment of both acute myelocytic and acute lymphocytic leukemia.

Animals↗

Susceptibility of inbred strains of mice to Trypanosoma congolense: correlation with changes in spleen lymphocyte populations.

A comparison was made of the susceptibility of eight inbred strains of mice to infection with Trypanosoma congolense. Marked differences in susceptibility as judged by survival were found between the different strains. The capacity of certain strains to survive longer than others appeared to be related to their ability to limit the numbers of trypanosomes in the circulation. There was no difference in the infectivity of T. congolense for mice of high and low susceptibility. Furthermore, the findings of similar prepatent periods suggested that the initial replication rate was similar in the different strains. These findings suggested that the level of parasitaemia in different strains of may reflect differences in the nature of quality of the immune response to the trypanosome. In all of the strains of mice a marked increase in splenic B and null lymphocytes was found. This, allied to the finding of an increase in the background plaque-forming cells to sheep erythrocytes, indicated, as suggested by other workers, that trypanosome infection results in a non-specific polyclonal activation of lymphocytes, and that this affects primarily B lymphocytes. In strains of mice which survived longest, i.e. C57B1/6J and AKR/A, the increase in splenic B and null cells was less marked. Whether this is associated with a decreased susceptibility of these strains to polyclonal activation induced by trypanosome infection, or whether it is merely the result of lower levels of parasitaemia, remains to be determined. By comparing T. congolense infection in three strains of mice congenic at the H-2 locus, representing H-2a, H-2b and H-2k haplotypes, it was found that the susceptibility was not associated with the H-2 haplotype. The finding that (A/J X C57B1/6J)F1 hybrids were of similar susceptibility as the C57B1/6J parents indicated that the relative resistance of this strain is inherited as a dominant trait, although in the early stages of infection the F1 hybrids consistently showed somewhat higher levels of parasitaemia than the C57B1/6J mice. Athymic nude mice and surgically splenectomized mice were found to be more susceptible to T. congolense infection than intact mice of the same strain. However, the effect of splenectomy was much less pronounced in C57B1/6J mice than in the relatively more susceptible BALB/c/A mice.

Animals↗

A preliminary study of low-dose splenic irradiation for the treatment of chronic lymphocytic and prolymphocytic leukaemias.

21 patients, 18 with chronic lymphocytic leukaemia (CLL) and 3 with prolymphocytic leukaemia (PLL), all B-lymphocyte origin and with progressive disease, were treated with a regime of low-dose splenic irradiation (SI). All patients experienced a rapid relief of disease-related symptoms. Following SI the total lymphocyte count (TLC) was markedly reduced in 18 patients. Partial to complete regression of splenomegaly occurred in 9 patients. Pre-existing anaemia of production failure type improved in 6 patients and as a result the haemoglobin rose to normal or near normal levels. SI caused the loss of T-, B- and Null-lymphocytes, but the loss of B-lymphocytes predominated. CLL/PLL became quiescent for long periods in 9 patients (CLL = 8; PLL = 1) but remained progressive in the other 9, all CLL. SI had no demonstrable effects on TLC, splenomegaly or anaemia in the 3 remaining patients (2 CLL, 1 PLL). The treatment was well tolerated by all, and side effects were almost absent. Transient reduction of neutrophils and platelets occurred commonly. No patient with initially normal neutrophil and platelet counts developed irreversible neutropenia or thrombocytopenia. In view of these effects, the ease of administration and the lack of side effects, further evaluation of low-dose SI, particularly in comparison with other regimes, seems worthwhile.

Adult↗

Natural killer (NK) activity and interferon (IFN) production by a fraction of spleen and blood lymphocytes in swine.

After carbonyl iron treatment and gradient isolation, spleen and blood pig lymphocytes exhibited NK activity and produced IFN after viral induction. Removal of plastic-adherent cells, including the majority of B cells, did not change these activities. The plastic-non-adherent cells were further separated into two subsets of roughly similar size by panning using a monoclonal, anti-T, and anti-null cell antibodies (81 + cells). NK activity and IFN production were found in the 81 - cell fraction. A significantly higher proportion of null lymphocytes from blood and of splenic Fc-gamma receptor-bearing lymphocytes was also found among the 81 - cell fraction as compared to the 81 + fraction, without any change among other subsets. Similar proportions of helper (PT4+), cytotoxic (PT8+) and total T cells (MSA4+) were found among lymphocytes bound to target K562 cells and among the whole lymphocyte population. In contrast, lymphocytes that bound K562 cells demonstrated a striking increase in the proportion of Fc-gamma receptor-positive cells of high affinity. These results show that NK cells and IFN-producing cells are mainly included in the same blood and spleen fraction, and suggest that among 81 - cells only those expressing an Fc-gamma receptor of high affinity are active.

Animals↗

Frequent discordance of the light-chain isotypes expressed by serum monoclonal components and leukaemic B-cells.

In B-cell malignancies, it is generally held that the monoclonal components (MC) are produced by the malignant clones. Genetic relatedness implies the concordant expression of light-chain (LC) isotypes in the MC and at the surface of the malignant lymphocytes. We reviewed a series of 91 B-cell leukaemias, immunophenotyped by flow cytometry in our laboratory. A serum MC had been sought in 75 of these patients, and had been found in 23 (31%). Biclonal serum components were detected in three cases. LC concordance could not be assessed in three cases of surface LC-null lymphocytes. Of the 23 MC studied in 20 patients, light-chains were discordant in 39%, mostly due to kappa MC in lambda leukaemias. The origin of LC discordance remains speculative. It could be due to the emergence of subclones with the same primal VDJ gene rearrangement or, alternatively, to the development of new B-cell clones escaping immune surveillance from deregulated T-cells.

Aged↗

Expression of gamma/delta T cell receptors in porcine thymus.

Swine possess an extraordinarily high number of T lymphocytes with the phenotype CD4-CD8- in peripheral blood as well as in lymphoid tissues. This subpopulation is subdivided into at least four subsets defined by the expression of CD2 and three biochemically distinct gamma/delta T cell receptors. The four subsets differ largely in their pattern of lymphoid homing in that CD2- subsets, historically referred to as null lymphocytes, predominate in the circulating pool, whereas CD2+ subsets are enriched in lymphoid tissues. Here we document the expression of all three types of gamma/delta T cell receptors by CD4-CD8- porcine thymocytes, which provides the first evidence for a thymic origination of all subsets of porcine gamma/delta T lymphocytes. The biochemical analysis shows that three distinct gamma-chains form disulfide-bonded cell surface heterodimers with a common delta-chain and that glycosylation of all chains is already completed within the thymus. Surprisingly, CD2- subsets, which are known to be enriched among thymic emigrants and which numerically predominate in peripheral blood, are underrepresented in the thymus, suggesting a high export rate.

Aging↗