Immune function at diagnosis in relation to responses to therapy in acute
lymphocytic leukemia of childhood
DG Jose, H Ekert, J Colebatch, K Waters, F Wilson and D O'Keefe
Tests of immune capacity were performed on blood from 49 children with
newly diagnosed, untreated acute lymphocytic leukemia, and relation to
prognosis was determined. Patients were treated with multiple-drug therapy
and prophylactic cranial irradiation. Median follow-up time was 16 mo
(range 10--37 mo). Principal unfavorable findings at diagnosis were
absolute numbers of T lymphoid cells outside the range 850-- 2500/mul
blood, absence of whole blood responses to phytohemagglutinin in vitro, a
low titer of complexed antibody, and the presence in serum of free leukemic
blast cell membrane antigen. Fourteen patients showed two or more
unfavorable findings at diagnosis. Eleven of these have died. Four of the
remaining 35 patients have died. A shorter duration of first remission was
found among patients with abnormal numbers of T cells at diagnosis. The
findings suggest that the immunologic capacity of the patient at diagnosis
is an important determinant in responses to therapy.
Volume 47,
Issue 6,
pp. 1011-1021,
06/01/1976
Copyright © 1976 by The American Society of Hematology
