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Blood, Vol. 95 No. 10 (May 15), 2000:
pp. 3219-3222
Chronic neutropenia mediated by Fas ligand
Jin Hong Liu,
Sheng Wei,
Thierry Lamy,
P.
K. Epling-Burnette,
Gordon Starkebaum,
Julie Y. Djeu, and
Thomas P. Loughran Jr
From the H. Lee Moffitt Cancer Center and Research Institute, the
Veterans Administration Hospital, and the Departments of Internal
Medicine, Immunology/Microbiology, and Biochemistry/Molecular Biology;
University of South Florida, College of Medicine, Tampa, FL; and the
Veterans Administration Puget Sound Health Care System and Department
of Medicine, University of Washington School of Medicine, Seattle, WA.
Chronic neutropenia, often associated with rheumatoid arthritis, is
a characteristic finding in large granular lymphocyte (LGL) leukemia.
The mechanism of neutropenia is not known. Normal neutrophil survival
is regulated by the Fas-Fas ligand apoptotic system. We hypothesized
that neutropenia in LGL leukemia is mediated by dysregulated expression
of Fas ligand. Levels of Fas ligand in serum samples from patients with
LGL leukemia were measured with a Fas ligand enzyme-linked
immunosorbent assay. The effects of serum from patients with LGL
leukemia on apoptosis of normal neutrophils were determined by flow
cytometry and morphologic assessment. High levels of circulating Fas
ligand were detected in 39 of 44 serum samples from patients with LGL
leukemia. In contrast, Fas ligand was undetectable in 10 samples from
healthy donors. Serum from the patients triggered apoptosis of normal neutrophils that depended partly on the Fas pathway. Resolution of
neutropenia was associated with disappearance or marked reduction in
Fas ligand levels in 10 of 11 treated patients. These data suggest that
high levels of Fas ligand are a pathogenetic mechanism in human disease.

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