Marker profiles of human leukemia and lymphoma cell lines

By means of the multiple marker analysis, a total of 55 human leukemia-lymphoma cell lines which included 15 T-cell, 30 B-cell, four myelomonocytic-cell, and six non-T, non-B cell lines was characterized for their marker profiles. The multiple markers used included a number of cell surface markers as detected by either rosette or immunofluorescence tests, enzyme assays, cytogenetic analysis, and certain functional assay. Based on the criteria previously defined it was found that all the cell lines were proved to represent original leukemia-lymphoma of ALL, AML, CLL, CML in blastic phase or variety of lymphomas. The monoclonality, a "frozen" state at a specific state of differentiation-maturation, and cytogenetic marker in each leukemia-lymphoma cell line were remarkable common properties and were stable for years of cultivation. Similar, if not identical, general characteristics were observed in the study on 344 cases of uncultured fresh leukemia-lymphomas by the multiple marker analysis. While no single marker specific to any type of tumor was found, the study offers not only a basis for better understanding of the biology of leukemia-lymphoma but also an insight into normal hematopoietic cell differentiation in man.

The influence of histologic type on survival in non-Hodgkin's lymphoma

Histologic groups in 231 cases of malignant lymphoma were correlated with survival data at 100 months from the time of initiation of the study. Patients in the first two decades of life fared comparably with adults, but those over 60 years of age showed a poorer survival trend. Seven favorable and four unfavorable histopathologic groups were found with collective median survivals of 83 and 16 months, respectively (P less than 0.001). The favorable group included three follicular classes (cleaved, mixed, and large noncleaved) and four diffuse classes (small lymphocytic, cleaved, Burkitt non-cleaved, and convoluted lymphocytic). The unfavorable group consisted of four diffuse classes (plasmacytoid lymphocytic, mixed, and small and large non-cleaved). The group of 88 patients with follicular lymphoma had significantly longer overall survival than the group of 143 patients with diffuse lymphomas. No significant differences in survival were noted within three grades of follicular involvement. The favorable and unfavorable diffuse lymphomas had collective median survivals of 82 and 16 months, respectively (P = 0.01). Significant survival differences due to pattern of nodal involvement (P = 0.01) were found in patients with mixed and large non-cleaved cell lymphomas, but not in those with cleaved cell lymphomas. The group with large cleaved cells had significantly longer survival than those with large non-cleaved cells. Patients with mixed and large non-cleaved cell lymphomas of the same nodal pattern had similar survival data.

Immunoregulatory T cell function in multiple myeloma

Multiple myeloma is a malignancy characterized by uncontrolled monoclonal B cell differentiation and immunoglobulin production. In most instances, there is concomitant reduction in polyclonal differentiation and immunoglobulin synthesis both in vivo and in vitro. In in vitro pokeweed mitogen-induced B cell differentiation assays, proliferation and polyclonal immunoglobulin secretion optimally requires T cell help and can be inhibited both by monocytes and suppressor T cells. Helper function and monocyte-mediated suppression are relatively radio-resistant whereas T suppressor function is sensitive to 2,000 rad x-irradiation. We have examined myeloma T cell subset function in this assay using recombinations of isolated patient and normal B cells, T cells, and T cell subsets. Monocytes were removed by a carbonyl iron ingestion technique, normal and myeloma T cells were fractionated on the basis of Fc receptors for immunoglobulin (Ig) G (Tgamma) or IgM (Tmu or T non-gamma), and proliferation and IgG secretion after co-culture determined by [(3)H]thymidine incorporation and radio-immunoassay, respectively. Myeloma B cells demonstrate quantitatively and qualitatively normal blastogenic responses and are appropriately regulated by either autologous or allogeneic T helper and suppressor subsets. Despite normal proliferation, however, myeloma B cells remain deficient in subsequent differentiation and immunoglobulin secretion even when co-cultured in the absence of monocytes or suppressor T cells and the presence of normal helper cells. Myeloma T cell populations, in contrast, are entirely normal in helper capacity over a range of T:B ratios but are markedly deficient in radiosensitive and concanavalin A-induced suppressor activity. T suppressor cell dysfunction in multiple myeloma is apparently due to a deficit in the T non-gamma suppressor subset, whereas Tgamma cells, although proportionately reduced, are functionally normal. This unique T suppressor deficit reflects the heterogeneity of suppressor mechanisms in this disease and may represent a compensatory response to the monoclonal proliferation or the involvement of regulatory T cells in the pathogenesis of the malignancy.

Indomethacin-mediated enhancement of lymphocyte response to mitogens in healthy subjects and lung cancer patients

Indomethacin (prostaglandin synthetase inhibitor) was found to be capable of enhancing the mitogen-induced lymphocyte proliferative responses of healthy subjects and patients with lung cancer. A whole-blood culture technique was used. Indomethacin had no mitogenic activity. We observed a greater enhancement of lymphocyte response by indomethacin in weak responders as compared with strong responders in healthy subjects and lung cancer patients. A greater enhancement was also noted in lung cancer patients with active disease as compared with lung cancer patients in remission. In a separated cell culture system, the indomethacin exerted no effect on purified T cells in the absence of monocytes, while this agent exerted its enhancement effect on T lymphocyte response in the presence of autologous monocytes of lung cancer patients. This suggests that monocytes (suppressor cells) may secrete prostaglandins, which are responsible for the impairment of T lymphocyte response in lung cancer patients.

Expression of MLR-S in human myeloid, monocytic and erythroid cell differentiation

The present study describes a comparative study of MLR-S of various stages of fresh and cultured normal or leukemic myeloid, monocytic and erythroid cells. "One-way" MLR was performed, using a slightly modified whole blood method. Fresh leukemic myeloblasts from patients with acute myelocytic leukemia or chronic myelocytic leukemia, in blastic crisis possess a strong MLR-S whereas fresh granulocytes from patients with chronic myelocytic leukemia or from healthy subjects possess no MLR-S. Cultured leukemic myeloblasts from KG-1 or ML-1 cell line possess a very strong or a moderate MLR-S, whereas cultured leukemic promyelocytes from HL-60 cell line possess little or no MLR-S. Fresh leukemic erythroblasts or cultured leukemic erythroblasts from K-562 cell line exert a strong MLR-S whereas fresh erythrocytes exert no MLR-S. Cultured monoblasts from HPL-SK-1 or Murray cell line possess a very strong MLR-S whereas fresh monocytes from healthy subjects or from a patient with chronic monocytic leukemia possess a moderate MLR-S. These observations clearly indicate that there is a good correlation between the MLR-S and the cell differentiation stage. Observations in the present study also support the hypothesis that the MLR-S is a differentiation antigen which is completely lost by the terminal stage of myeloid or erythroid cell maturation or partially lost by the terminal stage of monocytic cell maturation.

Malignant lymphoma of pre-T-cell type terminating in acute myelocytic leukemia. A case report with enzymic and immunologic marker studies

We report a case of a T-zone malignant lymphoma of a cervical lymph node developing in a 25-year-old man. Only 14% of the marrow was originally involved, but within two months massive, leukemic dissemination ensued. The blast cells were unable to bind sheep erythrocytes (E) but expressed human thymus leukemia antigen (HTLA) and common ALL-stem-cell (cALL) antigen and had high terminal deoxynucleotidyl transferase (TdT) and acid phosphatase activity. These findings suggest a malignant lymphoproliferative disorder of pre-T-cell type. Complete remission was achieved with intensive chemotherapy. Two months later, acute myelomonocytic leukemia was diagnosed; at this time, over 90% of the blast cells were peroxidase, sudan black, and chloracetate-esterase positive. Consistent with loss of high TdT activity and HTLA and cALL antigens, 86% of the blasts now expressed Ia-like antigens. Cytogenetic studies demonstrated hyperdiploidy. Reports of granulocytic leukemia in lymphoma are reviewed in the context of the above findings and the hypothesis that a leukemogenic factor affects a multipotential stem cell.

Role of suppressor cells in depression of T lymphocyte proliferative response in untreated and treated Hodgkin's disease

The present study was undertaken to elucidate the type and the role of suppressor cells on T lymphocyte response to PHA in untreated and treated patients with Hodgkin's disease. The mean value of peripheral blood T lymphocyte response to PHA in untreated or treated patients was lower than that in healthy subjects. However, the difference was not statistically significant. There was no significant difference in T lymphocyte response between localized and generalized stage or between different cell types in both active and remission Hodgkin's disease patients. The mean T lymphocyte response to PHA of active patients without systemic symptoms (A), on the other hand, was significantly higher than that of active patients with systemic symptoms (B). The mean value of T lymphocyte response in the presence of monocyte-enriched E- cells was significantly lower, whereas the mean value in the presence of monocyte-depleted E- cells was only moderately lower than that in the absence of these non-T cells in active patients. The mean value of PHA response of T lymphocytes with monocyte-enriched or monocyte-depleted E- cells was only slightly lower than PHA response without these cells in remission patients. No suppressor cell activity of T cells was observed in both active and remission patients. The only significant difference in the suppressor cell activity of monocyte-enriched E- cells on the T lymphocyte response to PHA was observed between localized and generalized stage in patients with active disease. Unlike peripheral blood monocyte-enriched E- cells, the splenic monocyte-enriched E- cells possessed no significant suppressor cell activity on the splenic T lymphocyte response to PHA in active Hodgkin's disease patients. These observations suggest that the depression of in vitro cell-mediated immunity seen in patients with active Hodgkin's disease may be due to the non-specific suppression of T lymphocyte response by monocytes, in addition to a possibly intrinsic defect of T lymphocytes.

Appraisal of aspiration cytology in management of Hodgkin's disease

The value of aspiration cytology in the management of Hodgkin's disease is shown in this study of 228 patients and 403 aspirations; 385 from lymph nodes and 18 from extranodal masses. In all patients the initial diagnosis was established on surgical biopsy. Aspirates were helpful in staging, defining extension of unusual radiation fields, and in recognizing residual disease and relapses after therapy. Adequate material was obtained in 80% of aspirations. The diagnosis of Hodgkin's disease could not be established in the adequate cytologic sample in 9.9% of cases. In 5.5%, the diagnosis was that of benign reactive hyperplasia and in 4.4%, non-Hodgkin's lymphoma. Unsatisfactory material was usually obtained from nodes less than 1 cm in diameter or from residual lesions following radiation or chemotherapy. Only 14 of 93 such lesions proved to have active disease during follow up. There were no significant complications. Characteristics of the varied aspects of aspirated tumor cells found in Hodgkin's disease are described.

Splenic T and B lymphocytes and their mitogenic response in untreated Hodgkin's disease

The splenic T and B cell distribution in 79 patients with untreated Hodgkin's disease was quite similar to that in 15 control patients with non-Hodgkin's lymphoma or carcinoma. The mean T lymphocyte percentage was slightly higher in involved spleens than in uninvolved spleens of patients with Hodgkin's disease. There was no significant difference in the T and B cell distribution between tumor area and tumor-free area of the same spleens of Hodgkin's disease patients. Splenic T and B cell distribution did not correlate well with the clinical features of Hodgkin's disease. The splenic T cell percentage was significantly lower than that of the peripheral blood T cell percentage (P less than 0.05), while the splenic B cell percentage was significantly higher than peripheral blood B cell percentage (P less than 0.01) in 13 patients with untreated Hodgkin's disease. The splenic T lymphocyte response to PHA was significantly higher than the peripheral blood T lymphocyte response (P less than 0.05), and the splenic B lymphocyte response to PHA, in the presence of irradiated autologous splenic T lymphocytes, was also significantly higher than the peripheral blood B lymphocyte response (P less than 0.05) in 8 and 6 patients with untreated Hodgkin's disease, respectively. Since the control splenic cells, utilized in this study were obtained not from patients with non-neoplastic disease, but from patients with neoplastic disease other than Hodgkin's disease, our data are not conclusive, but only suggestive of normal T and B cell distribution and function in uninvolved spleens of patients with untreated Hodgkin's disease.

Malignant lymphoma with a high content of epithelioid histiocytes: report of T-cell variant of so-called Lennert lymphoma and review of the literature

The present report describes the first case of well-differentiated nodular lymphocytic lymphoma evolving into Lennert lymphoma of T-cell origin. A 58-year-old white female developed malignant lymphoma, well-differentiated, lymphocytic type, nodular, with focal bone marrow involvement (stage IV) in May 1975. She received 16 cycles of cyclophosphamide and prednisone combination chemotherapy which was completed in October 1976. A complete remission was achieved. In December 1976, she relapsed and was treated with cyclophosphamide, vincristine, bleomycin, and prednisone until May 1977. Lymphadenopathy decreased until August 1978, but then increased again. Biopsy of an axillary lymph node was interpreted as Lennert lymphoma. She received methotrexate, cyclophosphamide, vincristine, adriamycin, and prednisone beginning in September 1978. When last seen in November 1979, she was in partial remission. Lymphoid cells obtained from lymph node which was involved with Lennert lymphoma consisted of 93% standard E-rosettes and 83% gravity E-rosettes. Cytoplasmic immunoglobulin on frozen sections was negative, but acid phosphatase (ACP) and alpha-naphthyl acetate esterase reactions were strongly positive. These findings support a T-cell proliferation in Lennert lymphoma. A review of the literature reveals only four cases of Lennert lymphoma of T-cell origin.

Establishment and characterization of human B-lymphocytic lymphoma cell lines (BALM-3, -4 and -5); intraclonal variation in the B-cell differentiation stage

This study describes the establishment of three non-Burkitt B-lymphoma cell lines (BALM-3, BALM-4 and BALM-5) originating from the pleural effusion of a patient with a poorly differentiated diffuse lymphocytic lymphoma. The cells of BALM-3, -4 and -5 exhibited a number of properties which distinguish them from the usual B-cell type lymphoblastoid cell lines. Thus, they lacked the Epstein-Barr virus genome and had abnormal chromosome constitutions including a 14q+ marker. The presence of the identical surface immunoglobulin isotypes (gamma and chi chain determinants), and Ia-like B-cell-associated antigen in the cultured cells and in the "fresh" lymphoma cells in vivo was demonstrated. These findings strongly suggested that these cell lines have B-cell characteristics and were derived from the original tumor cell population. BALM-5 cells, however, showed somewhat different growth, cell surface marker profile and functional characteristics compared to those of BALM-3, and -4 cells. These variations suggest that the BALM-5 cells were probably at different stages of B-cell maturation than those of BALM-3 and -4, even though all three cell lines (established in three separate flasks) originated from the cells of the same pleural effusion of a lymphoma with monoclonal B-cell characteristics.

T-cell chronic lymphocytic leukemia: report of a case and review of the literature

We recently observed a unique case of T-cell type chronic lymphocytic leukemia, documented by cell surface marker analyses. Immunologic tests at the time of diagnosis were as follows: 1) skin tests were negative; 2) in vitro lymphocyte responses to antigens or pokeweed mitogen were absent; 3) in vitro lymphocyte responses to phytohemagglutinin, concanavalin-A or allogeneic cells were low but significant; and 4) stimulating capacity of leukemic T cells were absent. Chromosomal analysis of bone marrow showed a pattern of 45 chromosomes with a marker chromosome. Terminal deoxynucleotidyl transferase activity was very low. Patient responded extremely well to COP (cyclophosphamide-oncovin-prednisone) therapy. Patient died of recurrent transitional cell carcinoma while his leukemia was in complete remission, approximately 20 months after the diagnosis of T-cell CLL.

Human thymus cells: a study of rosette-forming capacity with unsensitized and sensitized erythrocytes of various species

Human thymus cells from 117 donors aged 2 months to 15 years, were studied for rosette-forming capacity with unsensitized and sensitized erythrocytes of various species. Viability of the thymus cells at the completion of isolation ranged from 95 to 99%. Over 90% of the total population of thymus cells were identified as T lymphocytes by either standard Es-rosette assay utilizing a 4 degree incubation with preceding centrifugation or T--LCL assay, on the average. Gravity Es-rosette assay high affinity Es-rosette assay, stable Es-rosette assay or active Es-rosette assay for identification of subsets of T lymphocytes indicate that most of the human thymus cells were capable of forming rosettes with unsensitized sheep erythrocytes at higher degrees of temperature with or without preceding centrifugation. Approximately half of the human thymus cells were also capable of forming rosettes with unsensitized allogeneic erythrocytes. Less than 3% of the thymus cells expressed receptors for the Fc portion of IgG (T gamma suppressor cells) whereas less than 1% of thymus cells expressed receptors for the Fc portion of IgM (T mu helper cells), indicating that most of the thymus cells are non-T mu/non T gamma cells. Only 1% or less of the thymus cells were identified as B cells by the SIg assay, the Em-rosette assay or the Ia-like antigen assay. There was no significant difference of any rosette assay between males and females or among various age groups.

Human myeloma cells and their strong stimulating capacity in 'one-way' mixed lymphocyte reaction: a comparative study with leukaemic B lymphoid cells

Cultured human myeloma cells (ARH-77, RPMI-8226 and U-266), like leukaemic B lymphoid cells, consistently exerted a strong stimulating capacity on allogeneic lymphocytes in the 'one-way' mixed lymphocyte reaction. An optimal stimulation was seen when a 1:1 ratio or 1:2 ratio of responding cell:stimulating cells of each cell line was utilized. The stimulating capacity of ARH-77 or RPMI-8226 cells was significantly diminished when a 1:4 ratio of responding cells:stimulating cells was utilized. Fresh bone marrow cells containing more than 80% plasma cells from a patient with multiple myeloma, on the other hand, failed to exert the stimulating capacity on two occasions. The striking difference between cultured myeloma cells and fresh plasma cells is that the Ia-like antigen is present on cultured myeloma cells, and this antigen is absent on fresh plasma cells. The relationship between the Ia-like antigen and the stimulating capacity in 'one-way' mixed lymphocyte reaction is discussed.

Cultured human leukemic non-T/non-B lymphoblasts and their stimulating capacity in "one-way" mixed lymphocyte reaction: suggestive evidence for early T-cell or B-cell precursors

It is now well recognized that a large proportion of cases with acute lymphoblastic leukemia are classified as non-T/non-B neoplastic disease. The origin of leukemic non-T/non-B cells is at present not known. It has been shown that fresh or cultured leukemic T lymphoblasts exert no stimulating capacity while leukemic B lymphoblasts exert a strong stimulation in "one-way" mixed lymphocyte reaction. It has also been shown that fresh leukemic cells from some patients with non-T/non-B acute lymphoblastic leukemia possess a strong stimulation while leukemic cells from other patients with this disease possess no stimulation on allogeneic lymphocytes. The present study shows that cultured leukemic lymphoblasts from 3 non-T/non-B cell lines (NALL-1, NALM-6 and NALM-16) consistently exert a strong stimulation on allogeneic lymphocytes. On the other hand, cultured leukemic lymphoblasts from 2 non-T/non-B cell lines (REH and KM-3) consistently fail to stimulate in "one-way" mixed lymphocyte reaction. Our data clearly support the speculation that leukemic non-T/non-B cells which possess the stimulating capacity may represent less differentiated leukemic B lymphoid cells (pre-B cells) and leukemic non-T/non-B cells which possess no stimulating capacity may represent less differentiated leukemic T lymphoid cells (per-T cells).

Isolation of T-cells, B-cells and macrophages by a two-stage adherence procedure

This communication describes a method to obtain enriched populations of T-cells, B-cells and macrophages. Spleen cells were initially fractionated on nylon wool columns. The nylon wool adherent fraction was removed by mechanical agitation and further separated on the basis of adherence to a coated-plastic surface in the presence of autologous serum. The tissue flask adherent population was removed with the aid of a rubber policeman. The nylon wool non-adherent and the tissue flask non-adherent and adherent fractions were characterized for the presence of cell surface markers, size, and functional activity and were identified as T-cells, B-cells and macrophages, respectively. The two-stage adherence procedure is simple to perform and does not require sophisticated equipment or expensive reagents.

Bronchogenic carcinoma in chronic lymphocytic leukemia

Fourteen cases of bronchogenic carcinoma were found in 191 patients with chronic lymphocytic leukemia seen at the Rosewell Park Memorial Institute, Buffalo, NY, from 1951 to 1976. Four of these were not diagnosed until the time of autopsy. There was an average lag of nine months between the onset of symptoms and signs suggestive of bronchogenic carcinoma and its diagnosis. In patients with chronic lymphocytic leukemia, a high index of suspicion for bronchogenic carcinoma is necessary fo its early detection.

In vitro functional studies of mononuclear cells in patients with CLL: evidence for functionally normal T lymphocytes and monocytes and abnormal B lymphocytes

In vitro functional studies of mononuclear cells from 34 patients with B-cell type CLL were investigated and the results of these studies were as follows: 1) The T lymphocytes from patients with CLL were capable of responding normally to PHA or PWM, of inducing allogeneic normal B lymphocytes to respond to these mitogens and of stimulating normally to allogeneic lymphocytes in "one-way" mixed lymphocyte reaction; 2) The monocytes from these patients were capable of enhancing the T lymphocyte response to mitogens and of stimulating normally to allogeneic lymphocytes; and 3) The leukemic B lymphocytes were incapable of responding to mitogens even in the presence of normal T lymphocytes and their enhancer cell activity on T lymphocyte response or their stimulating capacity on allogeneic lymphocytes was depressed. These observations suggest that the T lymphocytes and monocytes from patients with CLL are functionally normal while the leukemic B lymphocytes from these patients are functionally abnormal.

Chronic myelocytic leukemia terminating in blast cell crisis with lymphoblastic characteristics

A child with chronic myelocytic leukemia (CML), Philadelphia chromosome positive, developed a non-T cell, non-B cell, acute lymphocytic leukemia (ALL) during her blast cell crisis. The diagnosis was suggested by light microscopy and supported by histochemical stains and transmission electron microscopy. Immunologic studies showed the presence of a non-T, non-B leukemic blast population--indistinguishable from the most common form of ALL (null cell type). Markedly elevated terminal deoxynucleotidyl transferase (TdT) activity was found. The findings support the hypothesis that the primary cell involved in CML is a stem cell with pluripotential characteristics; frequently the blast cell proliferative phase terminates in acute myeloblastic leukemia, but it may also terminate in ALL. The TdT activity may be evidence of leukemic transformation and not necessarily related to the thymic origin of the lymphocytes.

Unique leukemic non-T/non-B lymphoid cell lines (REH and KM-3): absence of MLR-S and presence of suppressor cell activity for normal T-cell response

The present study unequivocally demonstrates that leukemic non-T/non-B lymphod cells from three cell lines (NALL-1, NALM-6 and NALM-16) possess a strong stimulating capacity in "one-way" mixed lymphocyte reaction (MLR-S), while leukemic cells from two non-T/non-B cell lines (REH and KM-3) possess no MLR-S. It is speculated that leukemic non-T/non-B lymphoid cells with MLR-S may represent less differentiated leukemic B cells and leukemic non-T/B lymphoid cells without MLR-S may represent less differentiated leukemic T cells. The REH or KM-3 cells without MLR-S also act as suppressor cells on normal T lymphocyte response to mitogen and allogeneic cells by secreting a potent suppressor activity. The MOLT-4 leukemic T lymphoid cells with no MLR-S, on the other hand, do not act as suppressor cells on T lymphocyte response. The soluble factor(s) secreted by the REH or KM-3 cell line is non-toxic to T lymphocytes and heat-sensitive. A significant suppression of T lymphocyte response is still observed, even when the active material is only present for one hour prior to the addition of PHA or it is added several days after the beginning of cultures. The biological and physico-chemical nature of this active material has not been defined. Further studies are currently in progress for biological and physico-chemical characterization and isolation of the active material.

Use of stimulating capacity of mixed lymphocyte reaction (MLR-S) as a possible marker for the cell-origin of null-cell acute lymphoblastic leukaemia

The recent introduction of surface marker analysis indicates that the T-cell ALL represents 15--25%, the B-cell ALL represents less than 5% and the null-cell ALL represents more than 70% of cases. The origin of leukaemic null-cells is at present not clear. The present study shows that fresh leukaemic cells from five patients with null-cell ALL exerted a strong stimulating effect while the leukaemic cells from three patients with null-cell ALL failed to stimulate in 'one-way' MLR. Cultured leukaemic cells from three null-cell lines (NALM-16, NALL-1 and MOLT-10) consistently exerted a strong stimulation while leukaemic cells from one null-cell line (REH) exerted little or no stimulation on allogeneic lymphocytes. Leukaemic null-cells from the NALM-,6 line exhibited a lesser but significant stimulation in 'one-way' MLR. These observations lead us to speculate that leukaemic null-cells which possess a stimulating capacity may represent less differentiated leukaemic B lymphoid cells (early B-cell precursors) and leukaemic null-cells which possess no stimulating capacity may represent less differentiated leukaemic T lymphoid cells (early T-cell precursor).

Stimulating capacity of blast cells from patients with chronic myelocytic leukaemia, in blastic crisis in 'one-way' mixed lymphoycte reaction: lack of evidence for T lymphoblastic conversion

It has long been suggested that the blastic transformation in some patients with Ph1-positive chronic myelocytic leukaemia (CML) may be lymphoid in nature. It has recently been postulated that some patients with CML may undergo a T lymphoblastic crisis because the leukaemic blasts from these patients have high terminal deoxynucleotidyl transferase (TdT) activity and that some patients may undergo a non-T/non-B lymphoblastic crisis since leukaemic blasts from a majority of morphologically lymphoid type CML-BC cases react with antiserum specific for non-T/non-B acute lymphoblastic leukaemia (ALL). The present study shows that leukaemic blasts from each of six patients with Ph1-positive chronic myelocytic leukaemia-blastic crisis (CML-BC) exerted a strong stimulation on allogeneic lymphocytes in 'one-way' mixed lymphocyte reaction. There was no apparent difference in stimulating capacity between morphologically myeloid type (four cases) and lymphoid type (two cases). The stimulating capacity of leukaemic blasts from patients with CML-BC was quite similar to that of blasts from all patients with acute myeloblastic leukaemia (AML) and from some patients with non-T/non-B type ALL. Leukaemic blasts from a patient with T-cell type ALL and cultured leukaemic T lymphoblastoid cells (2 lines) consistently failed to stimulate while cultured leukaemic null-cells (4 lines) consistently exerted a strong stimulation in 'one-way' mixed lymphocyte reaction. These observations suggest that leukaemic cells from patients with CML-BC, morphologically lymphoblastic type, are not T lymphoblasts although the possibility that these cells are non-T/non-B lymphoblasts cannot be ruled out entirely.

Effects of radiochemotherapy and splenectomy on cellular immunity in long-term survivors of Hodgkin's disease and non-Hodgkin's lymphoma

Thirty-six patients treated for Hodgkin's disease (HD) or non-Hodgkin's lymphoma (NHL) who had been in complete remission and off all therapy for greater than two years were examined for evidence of immunosuppression. All patients were found to have marked depression of their lymphocyte blastogenic response to phytohemagglutinin (PHA) and of their skin test responses. No abnormalities of serum protein or immunoglobulins were found. T cells were significantly lower than normal in patients who had had Hodgkin's disease, but not in those who had had NHL. B cells, on the other hand, were significantly elevated in both groups. Splenectomy elevated the total lymphocyte count, while those who had not had a splenectomy had lower than normal lymphocyte counts. B cells were elevated while T cells tended to be lower in both splenectomy and nonsplenectomy groups, though only in the nonsplenectomized patients did this reach statistical significance. PHA response tended to be higher in patients with less advanced disease and less extensive treatment than in those with more advanced disease and more extensive treatment, although there was no statistically significant difference. Skin test response though, was shown to correlate well with both stage of disease at diagnosis and extent of treatment.

T-lymphocyte dependency of B-lymphocyte blastogenic response to phytomitogens

Human peripheral blood T and B lymphocytes were separated by a method based on the stable rosette formation of T lymphocytes with neuraminidase-treated sheep erythrocytes, followed by centrifugation over a Ficoll-Hypaque gradient. Monocytes were isolated from the T-depleted B lymphocyte preparation by allowing the monocytes to ingest iron particles and by subsequent centrifugation over a Ficoll-Hypaque gradient. The T lymphocytes responded extremely well to PHA and very well to PWM, while the B lymphocytes were unresponsive to either PHA or PWM. However, when the B lymphocytes were cultured together with irradiated autologous or allogeneic T lymphocytes (1:1, 1:2 or 1:4 ratio), both PHA and PWM became mitogenic to B lymphocytes. Irradiated T lymphocytes alone did not respond to either PHA or PWM, indicating that the 3H-thymidine incorporation seen in the mixed-cell culture was due to the activation of unirradiated B lymphocytes. The B lymphocytes failed to respond to these phytomitogens in the presence of lower concentrations of irradiated T lymphocytes. The monocytes were found to be incapable of helping the B lymphocytes to respond to PHA or PWM.

Stimulating capacity of fresh and cultured human leukaemic lymphoid and myeloid cells in 'one-way' mixed lymphocyte reaction

Fresh normal peripheral blood B lymphocytes possess a strong stimulating capacity while fresh thymus cells or fresh peripheral T lymphocytes possess a weak, but significant stimulating capacity on allogeneic lymphocytes in `one-way' mixed lymphocyte reaction. Fresh leukaemic T lymphoid cells from patients with T-cell ALL or T-cell CLL exert little or no stimulation on allogeneic lymphocytes. Fresh leukaemic B lymphoid cells from patients with B-cell CLL or B-cell HCL, on the other hand, exert a lesser stimulation on allogeneic lymphocytes, as compared to that of normal B lymphocytes. Leukaemic myeloblasts from patients with AML or Ph<sup>1</sup>(+) CML-BP exert significantly higher stimulation than leukaemic lymphoid cells in `one-way' mixed lymphocyte reaction (P<0.05). Cultured leukaemic T lymphoid cells (MOLT-4) possess no stimulating capacity, cultured leukaemic B lymphoid cells (BALM-2) possess a moderate degree of stimulating capacity and cultured leukaemic, possibly myeloid, cells (NALM-1 and K562) possess vigorous stimulation on allogeneic lymphocytes. The stimulating capacity of NALM-1 or K562 cells is significantly higher than that of BALM-2 cells (P<0.01 or P<0.05, respectively) and that of MOLT-4 cells (P<0.001). These observations suggest that the stimulating capacity of leukaemic T or B lymphoid cells may have been completely or partially lost during the process of leukaemogenesis. Since we do not have an opportunity to study the stimulating capacity of normal myeloblasts, it is not known whether the stimulating capacity of leukaemic myeloblasts, which is found to be very strong on allogeneic lymphocytes, may have been modified during the process of leukaemogenesis.

Lymphoblastogenesis inhibitory factor produced by human lung cancer cell lines

A comparative study of the inhibitory effect of cell-free supernatants (CFS) from human lung cancer cell lines (ChaGo and PC-1) and from a human embryo fibroblast cell line on lymphocyte blastogenesis indicated that both lung cancer cell lines produce a large amount of the inhibitory factor while the production of such a factor from a control noncancer cell line is essentially very minimal or absent. The inhibitory effect of CFS of the lung cancer cell lines is not due to direct cytotoxicity. The inhibitory effect is found to be partially sensitive to heat treatment. A significant inhibition is still seen, even when the CFS of the lung cancer cell lines were present for 1 hour prior to the addition of phytohemagglutinin (PHA).

Impaired lymphocyte blastogenic response in patients with colon adenocarcinoma: effects of disease and age

The in vitro blastogenic response of 76 patients with colon adenocarcinoma and 29 age-matched normal healthy volunteers was compared. An age-related decline in cellular immunocompetence was observed in both the patient and control group. Within each age interval, the patients' blastogenic responses were lower than the controls' and the rate of decline of the blastogenic response in the patient group was greater in magnitude, suggesting that their disease state also contributed to loss of cellular immunocompetence. Thus, both increasing age and presence of tumor are factors that contribute to the decline the immunocompetence in patients with colon adenocarcinoma.

Establishment and characterization of leukemic T-cell lines, B-cell lines, and null-cell line: a progress report on surface antigen study of fresh lymphatic leukemias in man

Permanent human hematopoietic cell lines representing T-cell, B-cell and non T/non B (null-cell) leukemia have been established. Comparative analyses were made for their phenotype characteristics. A number of characteristics common within the 7 T-cell lines studied or distinct from other leukemia-type lines were described. Usefulness, validity and limitation of these findings are discussed in connection to the attempt at classification of ALL, CLL and blastic phase of CML. The great majority of CLL were SmIg+-B-cell leukemia and a single case of T-cell CLL was documented. Except 10% as T-cell ALL and a single case of B-cell ALL, the majority of ALL were found to be the non T/non B ALL. Nevertheless, little evidence was suggested from the present study in favor for a notion that the T-cell ALL and the non T/non B ALL are two distinct diseases.

Whole blood microculture assay of human lymphocyte function

A whole blood microculture assay is described for measuring lymphocyte reactivity to mitogenic and antigenic stimulants. This assay employs heparinized whole blood, serum-free culture medium, microtiter plates, and a Multiple Automated Sample Harvester (MASH). When this assay is compared to other leukocyte assays, its major advantages include (1) the utilization of fewer lymphocytes per microculture, thuus reducing the amount of blood required per test while increasing the number of test agents and replicate cultures which can be employed in any given experiment; (2) the conservation of mitogens, antigens, drugs, enzymes, hormones, lymphokines, and other test agents, some of which are either expensive of difficult to prepare in large quantities; (3) the elimination of lymphocyte isolation and purification procedures which may disrupt the relative proportion of T cells, B cells and antigen-processing cells; and (4) the application of an automated harvester which simplifies and expedites procedures required for processing cells for liquid scintillation counting.

T and B lymphocytes. Exclusive role as responders and stimulators in human one-way mixed lymphocyte reaction

Four different combinations of one-way mixed lymphocyte reactions between human peripheral blood T and B lymphocytes (at a ratio of 1:1), purified by the E-rosetting technique, were carried our. A significant mixed lymphocyte reaction was observed only in a combination in which T lymphocytes, as responding cells, and B lymphocytes, as stimulating cells, were utilized. No significant mixed lymphocyte reaction was noted in the other three combinations of cells, using T or B lymphocytes as responders and T lymphocytes as stimulators, and also B lymphocytes as both responders and stimulators. Mixed lymphocyte reactions between T lymphocytes as responders (at constant concentration) and T and B lymphocytes as stimulators (varying proportions) showed that the response decreased proportionately with decreasing numbers of B cells and increasing numbers of T cells used as stimulators. Addition of increasing numbers of stimulating T cells to a constant number of stimulating B cells did not suppress or enhance the T-cell response to B cells. These observations indicate that the human peripheral blood T and B lymphocytes play an exclusive role as responding cells and stimulating cells, respectively.

Human thymus cells: blastogenic response to mitogens, antigens and allogeneic cells

Over 90 per cent of the thymus cells from each of twenty-six donors were T lymphocytes, identified by E-rosetting and less than 3 per cent of the cells were B lymphocytes identified by EAC-rosetting. With advancing age, the proportion of T lymphocytes decreased while that of B lymphocytes increased. The degree of (3H)thymidine incorporation of thymus cells was inversely proportional to the age of the thymus-cell donor. The PHA or PWM- induced blastogenic response of thymus cells gradually increased with advancing age when the response was expressed as the stimulation index. However, the actual rate of (3H)thymidine incorporation in all three groups was rather similar when cells were cultured with mitogens. The difference in stimulation index was due to the variation in incorporation rate in cultures without stimulants. The PHA response was approximately four-fold higher than that of PWM response. Thymus cell response to allogeneic lyphocytes, on the other hand, had no correlation with the age of thymus donor. The most surprising result in the present study was that the thymus cells from each of ten donors, aged 1-14 years, were incapable of responding to all four different recall antigens. Peripheral blood lymphocytes from nine to ten randomly selected age-matched children responded very well to one or more antigens.

T- and B-lymphocytes in chronic lymphocytic leukemia: correlation with clinical and immunologic status of the disease

T- and B-lymphocyte count were correlated with clinical and immunologic status of 59 patients with chronic lymphocytic leukemia. The mean total T-cell count was slightly lower than normal in patients in complete remission, within normal limits in those in partial remission, and significantly higher in those with active disease. The mean total B-cell count, however, was slightly elevated in patients in complete remission and those in partial remission, and markedly elevated in those with active disease. The T-cell count correlated well with the duration of disease in patients in remission: The mean count was within normal range in those patients with disease of less than 3 years, whereas for those patients with disease of 3-12 years, a significant reduction was observed. The T-cell count was well correlated with the status of skin test response of patients with either complete or partial remission; the B-cell count did not correlate with immunoglobulin levels in patients with this disease.

Adjuvant immunotherapy in bronchogenic carcinoma

Ten patients with locally far advanced bronchogenic carcinoma were treated with autologous tumor vaccine after a radical surgical resection. Three of 10 patients treated with tumor vaccine are alive (median survival of 26 months) whereas all nine patients in the control group are dead (median survival of 6.5 months). Active immunotherapy adjunct to radical surgery appeared to improve cellular immunity of the treated patients in the postoperative period, and the migration inhibition test indicated sensitization of treated patients against their tumor.

Enhanced E- and EAC-rosette formation by neuraminidase

Pre-treatment by neuraminidase of lymphocytes obtained from peripheral blood of normal donors significantly enhanced E- and EAC-rosette formation. Of other lymphoid cells only spleen cells showed significant enhancement of E-rosettes. The EAC-rosettes slightly increased when the peripheral blood lymphocytes from patients with acute lymphoblastic leukemia or chronic lymphocytic leukemia and MOLT-4 lymphoid cells were pre-treated with this enzyme. The EAC-rosettes were not increased by neuraminidase treatment of phytohemagglutinin-induced blasts, thymus cells or spleen cells. Pre-treatment of peripheral blood lymphocytes with neuraminidase also increased the proportion of stable E-rosettes resistant to incubation at 37 degrees C and to vigorous shaking. Various concentrations of neuraminidase (1-100 U/ml) produced enhancement of E- and EAC-rosettes with the highest activity at 25 and 50 U/ml. Neuraminidase treatment of sheep red blood cells failed to increase the proportion of E-rosettes of peripheral blood lymphocytes. The increased rosette forming capacity induced by neuraminidase is probably related to changes in lymphocyte surface properties.

Enhancement of "one-way" human mixed lymphocyte reaction by cholinergic agents

"One-way" mixed lymphocyte reaction was not enhanced when the cells were allowed to be exposed to acetylcholine or carbamylcholine at a concentration of 0.01-1.0mumole/ml during the entire period of culture. It was thought to be due to cytotoxicity effect of these agents on responding cells. When the responding cells were incubated with cholinergic agents for 1 hr prior to washing the cells and setting up the mixed cell culture, "one-way" mixed lymphocyte reaction was enhanced. However, when the stimulating cells were similarly treated with either agent, no enhancement of "one-way" mixed lymphocyte reaction was observed. These observations indicate that cholinergic agent induces enhancement of mixed lymphocyte reaction by affecting only the responding cells and not the stimulating cells.

Human thymus cells. Excellent responders but poor stimulators in 'One Way' mixed lymphocyte reaction

Human allogeneic 'one-way' mixed lymphocyte reactions between thymus cells and thymus cells were entirely absent. Of twenty-one mixed lymphocyte reactions between peripheral blood lymphocytes as responding cells and thymus cells as stimulating cells, only eleven had a weak but significant reaction. In contrast, a highly significant response was observed in each of eighteen mixed lymphocyte reactions between thymus cells as responding cells and peripheral blood lymphocytes as stimulating cells and in each of eleven mixed lymphocyte reactions between peripheral blood lymphocytes and peripheral blood lymphocytes. These findings indicate that the thymus cells (T lymphocytes) possess excellent proliferative capacity, with little or no stimulating capacity, while peripheral blood lymphocytes (T and B lymphocytes), on the other hand, are good responders, as well as good stimulators, in the mixed lymphocyte reaction.

Thoracic duct cannulation in a patient with lung cancer

Previously the authors demonstrated limited effectiveness of tumor specific active immunotherapy adjunct to radical surgery in patients with lung cancer. In order to improve the therapeutic effectiveness, a patient with inoperable lung carcinoma was treated with a radical surgery, tumor vaccination, and "unblocking procedures" which consisted of splenectomy and throacic duct canulation. In vitro studies demonstrated the evidence of sensitization of the patient against his own tumor, removal of blocking factor by the thoracic duct fistual from the circulation.

Inhibition of mixed lymphocyte reaction by thoracic duct lymph: removal of inhibitory effect by thoracic duct drainage in lung cancer

The inhibitory effect of the thoracic duct lymph of a patient with lung cancer on the "one-way" mixed lymphocyte reaction without cytoxicity is unequivocally demonstrated. The effect seems to be dose related. A moderate inhibition of mixed lymphocyte reaction is still observed, even if the responding cells are preincubated in the thoracic duct lymph for 1 hr only prior to the addition of stimulating cells. The inhibitory effect of thoracic duct lymph on the mixed lymphocyte reaction is no longer evident when the material is added 1-4 days after the beginning of culture. These observations suggest that the mechanism of the inhibitory effect of thoracic duct lymph may be a simple attachment of inhibitory factors to the receptor sites on the responding lymphocytes, causing interference in cell to cell interaction. The inhibitory effect of thoracic duct lymph collected 1 week after the thoracic duct drainage on mixed lymphocyte reaction is significantly lower than that of thoracic duct lymph collected at the beginning of the procedure. This indicates that the blocking effect of thoracic duct lymph can be easily removed by this technique; which is technically feasible in man. The interrelationship of the tumor-specific blocking factor, thoracic duct drainage, and tumor growth pattern are discussed with respect to the potential usefulness of this procedure as adjuvant immunotherapy in the management of patients with neoplastic diseases.

Human chorionic gonadotropin. Its inhibitory effect on cell-mediated immunity in vivo and in vitro

An inhibitory effect of human chorionic gonadotropin (HCG) on delayed hypersensitivity skin test responses in guinea-pigs given 4000 i.u. of HCG intraperitoneally, 1--7 days prior to skin testing, is presented. The effect of HCG on skin test responses lasted for at least 3 weeks. Inhibition of lymphocyte response to PHA or PPD in the HCG-treated guinea-pigs was also observed. Guinea-pig peripheral blood lymphocyte response to mitogen or antigen is unequivocally inhibited by HCG in vitro. The effect of this hormone is not due to direct cytotoxicity, and its inhibitory effect seems to be dose related. These observations support the hypothesis that the HCG and possibly other placental hormones might play an important role in protecting the foetus against maternal rejection.

Disparity in the production of lymphoblastogenesis inhibition factor by cultured human B and T lymphoid cell lines

A comparative study of inhibitory effects of cell-free supernatants from cultured human B and T lymphoid cell lines on lymphocyte blastogenesis indicated that the inhibitory effect of supernatant from B lymphoid cells on lymphocyte blastogenesis was significantly higher than that of supernatant from T lymphoid cells or from non-lymphoid neoplastic cells. The inhibitory effect of supernatant was reversible and dose-related. The inhibitory effect gradually diminished with time when the supernatant from B lymphoid cells was added to the culture, 1-3 days after the beginning of cultures. The supernatant of human B lymphoid cells was also found to be highly active in affecting the mouse thymus cell response. The biological nature of this inhibitory factor has not been defined. Both B lymphoid cell lines used in the present study contained Epstein-Barr virus (EBV) genomes while the T-cell line and the non-lymphoid neoplastic cell lines were free of EBV genomes. Sensitivity of the supernatant of B lymphoid cells to u.v. irradiation and heat suggests the possibility that the EBV genomes released into the culture medium may be responsible for inhibition of lymphocyte blastogenesis; resistance of this supernatant to DNase suggests that the EBV genomes may be double-stranded DNA.