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R Foa, MT Fierro, A Cesano, A Guarini, M Bonferroni, D Raspadori, R Miniero, F Lauria and F Gavosto
Dipartimento di Scienze Biomediche e Oncologia Umana, University of Torino,
Italy.
In 26 myeloid and lymphoid acute leukemia patients at presentation the
capacity to generate interleukin-2 (IL-2)-induced lymphokine-activated
killer (LAK) cells effective against the natural killer (NK)-resistant Raji
cell line, as well as the susceptibility of the blasts to normal peripheral
blood (PB) LAK cells and to autologous LAK effectors was analyzed. The
overall PB LAK activity against Raji cells was significantly lower in acute
leukemia patients compared with normal controls (mean, 1,473 +/- 971 SD
LU/10(8) LAK effectors v 3,340 +/- 1,862; P less than .001). The
sensitivity of the blasts to autologous LAK cells was also significantly
lower than to normal LAK effectors (517 +/- 593 LU/10(8) LAK effectors v
1,304 +/- 1,066; P less than .01). When the data were analyzed
independently, four patterns of behavior could be recognized. The
relatively largest group (9 of 26) included patients in whom effective LAK
cells could be generated against the Raji line, but in whom the blasts were
resistant to autologous PB-LAK effectors while being susceptible to normal
LAK cells (defective specific LAK activity). In 5 of 26 cases, an
incapacity to generate LAK activity against both allogeneic and autologous
target cells was observed (defective LAK generation). In six further cases,
the blasts were resistant to both allogeneic and autologous LAK
populations, though the latter were effective against the Raji line
(resistant blasts). The same defects could also be shown with bone
marrow-derived LAK cells. Only in six cases did the leukemic blasts appear
susceptible to autologous and allogeneic LAK cells. In four patients the
analysis could be repeated at remission, and in three a restoration of the
LAK function against the primary blasts was recorded. In the 10 cases
studied at relapse, the blasts were resistant to autologous LAK effectors
in nine and to normal LAK in seven. These data demonstrate that in most
acute leukemia patients with active disease, a defect of the LAK machinery,
either a deficient generation of LAK cells or the resistance of the blasts
to LAK effectors, may be documented, pointing therefore to a possible
contributory role of the LAK system in the control of leukemic cell growth.
In view of the frequent normalization of the autologous LAK activity at the
time of remission, immunotherapy with IL-2/LAK cells should be primarily
aimed to patients with minimal residual disease.
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| Copyright © 1991 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||