Correlation of response of aplastic anemia patients to antilymphocyte
globulin with in vitro lymphocyte stimulatory effect: predictive value of
in vitro test for clinical response
T Abe, H Matsuoka, S Kojima, Y Kamachi, I Tsuge, Y Kodera and T Matsuyama
Department of Pediatrics, Nagoya University School of Medicine, Japan.
Therapy with antilymphocyte globulin (ALG) has been shown to be effective
in restoring hematopoiesis to some patients with aplastic anemia. It would
be useful to have a method for predicting those likely to be responders
versus nonresponders. The mode of immunostimulatory action of ALG is of
interest in addition to its immunosuppressive action. We examined in vitro
the distribution of the proliferative responses of ALG-stimulated
peripheral blood mononuclear cells (PBMCs) obtained from 18 patients with
aplastic anemia, eight of whom responded to ALG and 10 who did not. We
found a significant difference in the proliferative response of PBMCs
obtained from the eight responders versus the 10 nonresponders (P less than
.01). Two-color flow cytometry analysis of the patients' PBMCs stimulated
by ALG in vitro showed that the CD4-positive subsets were activated to a
greater extent by ALG than the CD8-positive subsets. Moreover, a positive
correlation with the clinical response of patients to ALG with
granulocyte-macrophage colony- stimulating factor produced by their PBMCs
stimulated by ALG suggests that the immunostimulatory property of ALG has
an important role in the treatment of aplastic anemia. Our results suggest
that the clinical response to ALG therapy is correlated with its lymphocyte
proliferative effect in vitro, and indicates that the assessment of the
proliferative response of PBMCs in vitro would be useful in predicting the
clinical response to ALG therapy.
Volume 77,
Issue 10,
pp. 2225-2230,
05/15/1991
Copyright © 1991 by The American Society of Hematology
