|
|||||||||
|
|
|
|
|
|
|
|
|
|
|
JS Thompson, JM Herbick, LW Klassen, CD Severson, VL Overlin, JW Blaschke, MA Silverman and CL Vogel
Widespread clinical trials of leavo-tetramisole (levamisole) as an
immunopotentiating agent in rheumatoid arthritis, metastatic carcinoma, and
immunodeficiency states have been complicated by agranulocytosis (AGC) in
2.5%-13% of patients. Other than a relationship with prolonged high dosage,
very little is known regarding the pathogenesis of levamisole-induced AGC.
Whereas leukoagglutination was negative, fluorochromatic
microgranulocytotoxicity (GCY) tests were positive with serum from 10 of 10
acutely neutropenic patients. The antibody was IgM, reacted with 100% of
unrelated granulocytes, but not with T or B lymphocytes. Some sera also
reacted with monocytes and the myeloid cell line, K-562. Tests for
antigen-antibody complexes or cold autoantibodies were negative. Although
clinical evidence strongly suggests a haptene (drug) mechanism, in vitro
mixing experiments were also negative. An alternative choice parallels the
model of aldomet- induced Coombs'-positive hemolytic anemia. Finally, GCY
first became positive 2-3 mo prior to the onset of AGC on two patients,
suggesting the possibility of identifying those at risk well before the
onset of neutropenia.
This article has been cited by other articles:
| |||||||||||
 |
 |
 |
|||||||
 |
 |
 |
 |
 |
 |
 |
 |
||
| Copyright © 1980 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||
