Host defense deficiency in hairy cell leukemia and its correction by
leukocyte transfusion
EM Hersh, S Murphy, A Zander, K Dicke, DJ Stewart, H Toki and J Latreille
A similar defect host defense mechanisms in hairy cell leukemia was defined
in two patients. Surface-adherent monocytes were not detected in the
peripheral blood nor were monocytes that mediate antibody- dependent
cell-mediated cytotoxicity (ADCC) to isoantibody-coated human erythrocytes.
In addition, lymphocytes of both patients failed to show blastogenic
responses to concanavalin A (Con-A) and pokeweed mitogen (PWM) but showed a
vigorous response to phytohemagglutinin (PHA). Other immunologic
abnormalities were present but were either moderate in degree or were not
present in both patients. In vitro lymphocyte blastogenic responses were
fully restored by incubation of patients' leukocytes with a normal donor's
adherent monocytes. One patient received daily allogeneic leukocyte
transfusion for 4 days. This resulted in complete normalization of monocyte
adherence and ADCC that persisted for several months after transfusion and
was associated with hemotalogic improvement. Therapy in case 1 resulted in
correction of the blastogenic responses to Con-A and PWM. Thus, a host
defense defect in hairy cell leukemia has been defined in 2 patients and a
preliminary result suggests that therapy with leukocyte transfusions may be
useful in the postsplenectomy patient with an infectious complication and
should be explored further.
Volume 56,
Issue 3,
pp. 526-533,
09/01/1980
Copyright © 1980 by The American Society of Hematology
