Pure red cell aplasia and hypogammaglobulinemia associated with Tr-cell
chronic lymphocytic leukemia
T Nagasawa, T Abe and T Nakagawa
A 72-yr-old male with Tr-cell chronic lymphocytic leukemia (Tr-CLL)
exhibited pure red cell aplasia (PRCA) and hypogammaglobulinemia. During a
remission of Tr-CLL, and while receiving cyclophosphamide therapy, he
recovered from PRCA and hypogammaglobulinemia. To investigate the
pathogenesis of PRCA and hypogammaglobulinemia, we used coculture
techniques to study the effect of the malignant Tr cells on erythroid
colony formation and B-cell differentiation to immunoglobulin- producing
cells. Varying numbers of malignant Tr cells (2 X 10 to 2 X 10(5) cells)
were cocultured with 2 X 10(5) normal bone marrow cells. The malignant Tr
cells caused a marked reduction of erythroid colony formation in the plasma
clot system. This suppression of erythroid colony formation was reversed
when the malignant Tr cells were pretreated with antilymphocyte serum and
complement. There was no evidence of inhibitory effects in the serum or the
supernatant media of the malignant Tr cells stimulated with
phytohemagglutinin (PHA). The malignant Tr cells, stored at --80 degrees C
before transfusion, were also capable of suppressing autologous erythroid
colony formation after recovery from PRCA. In addition, malignant Tr cells
were found to have strong suppressor activity against the immunoglobulin
biosynthesis by allogeneic B cells. The in vitro suppressions of both
erythroid colony formation and B-cell differentiation provide an
explanation for the association of PRCA and hypogammaglobulinemia with
Tr-CLL.
Volume 57,
Issue 6,
pp. 1025-1031,
06/01/1981
Copyright © 1981 by The American Society of Hematology
