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P Gascon, N Zoumbos and N Young
We have analyzed natural killer (NK) cells in 43 patients with severe
aplastic anemia, using cytotoxicity assays and microfluorometry with
monoclonal antibodies, prior to and after treatment with antithymocyte
globulin (ATG). Before treatment, natural killer cell activity (NKa) in
both peripheral blood and bone marrow was markedly decreased in 76% of
patients as compared with normal controls. Although we have measured low
NKa in patients receiving large numbers of blood transfusions (means = 150
U of RBCs), six aplastic patients had low NKa in the absence of
transfusions, and the average number of transfusions in the total
population was low (means = 24). Purification of larger granular
lymphocytes (LGLs) from peripheral blood of aplastic anemia patients failed
to recover significant NKa. Most of these large granular lymphocytes showed
few azurophilic granules. NKa was appropriately enhanced in these patients
samples by exposure of mononuclear cells to either interleukin 2 (IL-2) or
interferon (IFN). Analysis of peripheral blood phenotypic markers showed
that cells bearing Leu 7 antigen were in the normal range in aplastic
anemia (means = 12% +/- 2%; normal = 16% +/- 2%), but there was a
deficiency of Leu 11+ cells (means = 8% +/- 2%; normal = 15% +/- 2%). The
number of Leu 11+ cells was well correlated with NKa. In 13 of 22 patients
treated with ATG, NKa returned to the normal range, and recovery of NKa was
correlated to hematopoietic recovery. Our results suggest that deficient
NKa is an intrinsic feature of aplastic anemia, and that the circulating
cells in this disease are of the pre-NK cell stage.
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| Copyright © 1986 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||
