Preserved cellular immunity in smoldering acute leukemia

&#34;Smoldering acute leukemia&#34;, a variant of acute myelogenous leukemia, has been recognized with frequent incidence in recent years. This is chracterized by benign clinical course, poor physical findings, leukopenia and mild anemia in the peripheral blood, and apparent infiltration of abnormal myeloblasts in the bone marrow. Immunological studies of the host defence mechanism were made, because the pathogenesis of its &#34;smoldering&#34; course has never been well understood. Nine cases, seen during last 2 years, were investigated for immunological profile, especially the cellular immunity. Purified protein derivative (PPD) skin test, i.e., tuberculin test, was found to be positive in 8 of 9 cases (88.9%). Dinitrochlorobenzene (DNCB) sensitization test showed to be positive in 4 of 6 cases examined (66.9%). Peripheral lymphocyte balstogenesis by stimulating with phytohemagglutinin (PHA) was evaluated using the smear counting method. The blastoid lymphocyte ratio was 55% at the median value (range: 31-68%), compared with 63% in normal young control (age: 25-32) and 41% in normal aged control (age: 60-75). In this report, the cellular immunity in smoldering acute leukemia was proved to be preserved at the normal level and to be more competent than that in aged group. The preserved cellular immunity is considered to explain the phenomenon of &#34;smoldering&#34;, in other words, the exacerbating proliferation of leukemic cells is suppressed by immuno-surveillance system.</p

Absence of anti-neocarzinostatin (NCS) antibody production in leukemia patients treated with NCS

Neocarzinostain (NCS) was first used by Hiraki and his colleagues for induction chemotherapy in acute leukemia. This new anti-tumor agent is a polypeptide with a high molecular weight of 10,700 daltons. Anti-NCS antibody was produced in rabbits administered NCS intramuscularly with or without adjuvant. The production of anti-NCS antibody in patients treated with NCS was investigated. Forty three leukemia cases of various types were examined totally 65 times. Two mg of NCS for four consecutive days by intravenous drip infusion followed by 7 to 10 days of pause was repeatedly administered. The total amounts ranged 8 to 174 mg and the total periods 4 to 87 days. The methods used to measure the antibody titer are the passive hemagglutination (PHA) test on microplate and the passive cutaneous anaphylaxis (PCA) reaction in guinea pigs. The sera of all patients showed only non-specific agglutination at less than 2(3) dilution by PHA test, and to confirm these results four patient sera were tested by PCA reaction. The production of anti-NCS antibody was not detected in patients by PHA test and PCA reaction. The anaphylactic reaction and other adverse reactions due to anti-NCS adtibody production were not demonstrated in patients. Anti-NCS antibody was not detected by these experiments in the dose schedule administered.</p

Normal chemotactic activity of granulocytes obtained by filtration leucapheresis

The chemotactic activity of granulocytes obtained by the Terumo Filtration Leucapheresis System (F.L.) was examined by the method of Boyden's chamber. The number of cells migrating through the Millipore filter was expressed as the chemotactic activity. The mean values were 117 for the F.L. and 122 in a control, in which cells were collected from the same donor blood using dextran sedimentation. The results suggested that the in vitro chemotactic function of granulocytes obtained by F.L. was within normal limits.</p

The relationship of cellular immunity to prognosis in acute leukemia

Forty-five patients with acute leukemia were compared on cellular immunity measures versus prognosis. The patients were treated according a multicombination therapy protocol. The purified protein derivative (PPD) test and dinitrochlorobenzene (DNCB) test on admission indicated low positive percentages. In acute non-lymphocytic leukemia (ANLL) patients, the 50% survival durations were 11 months in the PPD positive group and 6 months in the PPD negative group. In acute lymphocytic leukemia (ALL) patients, the 50% survival durations were 21 months in the PPD positive group and 13 months in the PPD negative group. Peripheral lymphocyte blastogenesis by phytohemagglutinin (PHA) stimulation was examined at various clinical stages. The stimulation indices were generally low, and no correlation was found between the PHA test and clinical stages. These cellular immunity measures appeared to reflect one aspect of the clinical condition in acute leukemia patients, and further studies are needed for predicting prognosis.</p

Importance of cell surface marker to the prognosis of non-Hodgkin's lymphoma.

We studied the correlation between the cell surface markers and prognosis of non-Hodgkin's lymphoma (NHL) patients treated in the Shikoku Cancer Center Hospital from 1980 to 1986. Thirty-one cases were selected on the basis of having a lymphnode as a primary lesion, having been immunophenotyped before chemotherapy, being in the intermediate histologic grade and being in stage II, III or IV. Thirteen cases of the T-cell type (T-lymphomas) and 18 cases of the B-cell type (B-lymphoma) were identified. The complete remission rate was 54% among T-lymphoma patients and 78% among B-lymphoma patients. The median length of survival was 12+ months in T-lymphoma and 26+ months in B-lymphoma. The survival rate of T-lymphoma patients was significantly lower than that of B-lymphoma patients. The importance of making surface marker studies was reappraised in our study.</p

Prognostic factors of peripheral T-cell lymphoma (PTL): statistical analysis on 30 patients.

&#60;P&#62;Peripheral T-cell lymphoma (PTL) is a distinctive clinical entity, albeit it comprises several diseases with histologically heterogeneous diagnoses. We studied prognostic factors on 30 patients diagnosed and treated at Shikoku Cancer Center Hospital. Clinical findings and laboratory data were evaluated by statistical analysis to investigate the important factors influencing survival duration. Variables influencing survival were stage, leukemic change, bone marrow infiltration (BMI), anti-human T-lymphocyte virus-type I antibody, white blood cell count, and lactate dehydrogenase (LDH). Multivariate analysis revealed high level of LDH and positive BMI as the important factors for short survival. Histological classifications of the Working Formulation and the T-lymphoma classification by Suchi et al. were also evaluated whether these were related with prognosis. Our data revealed that there was no significant relationship between histological subtype and survival duration. The study of prognostic factors provides valuable aids for us to understand the clinical characteristics of PTL patients with various backgrounds.</p

Successful Chemotherapy on a Pregnant Non-Hodgkin's Lymphoma Patient

We report a case of a non-Hodgkin's lymphoma (NHL) patient treated successfully with combination chemotherapy during pregnancy who delivered a full-term baby. A 29 year-old patient with cervical and inguinal lymphadenopathy in the 27th week of gestation was referred to our hospital. The diagnosis of lymph node biopsy was NHL (diffuse, large cell type with B-cell phenotype). Three courses of CHOP regimen (adriamycin, cyclophosphamide, vincristine and prednisolone) were given before delivery. The patient has been in complete remission for three years and her baby has been in normal development. Our case supports previous reports that chemotherapy in the third trimester may be given safely on NHL patients.</p