Transfer of the adenosine deaminase (ADA) gene of a B-lymphoblastoid cell line (LCL) to an ADA-deficient LCL by a microcell-mediated chromosome transfer technique

As a model of somatic cell gene therapy, a normal adenosine deaminase (ADA) gene was introduced into a B-lymphoblastoid cell line (LCL) established from a patient with ADA deficiency by microcell-mediated chromosome transfer (MMCT). A LCL derived from his mother was used as a gene donor. Seven fusion experiments were performed and hybrid cells were pipetted into 123 wells. After selection in the presence of deoxyadenosine, cells grew in 12 wells at Week 9 after fusion. Among these wells, ADA activity of hybrids was low in 4 wells, 130-280% of that of the donor LCL in 7 wells and very high in one well. Hybrid cells in 4 wells with ADA-positive cells were investigated for the time-course of expression of ADA activity. In one well, ADA activity was expressed until Week 36, while, in 3 wells, ADA activity decreased or was lost between 21-36 weeks after fusion. These findings indicate the transfer of chromosome 20 containing a normal ADA gene into recipient cells and the deletion of this chromosome from some part of the hybrid cells. Karyotyping at Week 35 or 37 revealed 47 chromosomes in about 30% of the cells in 2 wells, which suggests that these hybrids were relatively stable in culture.

1 alpha, 25-dihydroxyvitamin D3 enhances the up-regulation of interleukin-2 receptor (p55) by interleukin-2

The effect of 1 alpha, 25-dihydroxyvitamin D3 (1 alpha, 25(OH)2D3) on the expression of interleukin-2 (IL-2) receptor in activated T lymphocytes was examined. 1 alpha, 25(OH)2D3 enhanced the expression of IL-2 receptor (p55, Tac peptide) in phytohemagglutinin (PHA)-stimulated (3 days) human peripheral blood mononuclear cells (PBM) only in the presence of IL-2 without affecting the proliferation of the cells. This enhancement was dependent on the concentration of both IL-2 (0-1 U/ml) and 1 alpha, 25(OH)2D3(0-10(-7)M). The addition of interleukin-1 (IL-1, 0-100 U/ml), did not enhance the expression of IL-2 receptor in these cells in the presence of IL-2. Moreover, 1 alpha, 25(OH)2D3 had the same effect on two cell lines, Kit225 (an IL-2 dependent cell line established from a patient with T cell chronic lymphocytic leukemia) and YT (an IL-2 independent natural killer (NK)-like cell line from a patient with acute lymphocytic leukemia). Thus, 1 alpha, 25(OH)2D3 enhances the up-regulation of IL-2 receptor (p55) by IL-2 not only in activated T cells but also in the NK-like cell line.

Heterogeneous features of Ph-negative CML--possible existence of Ph-negative, bcr-rearrangement-negative CML

We have examined eight patients with Ph-negative chronic myelocytic leukemia (CML). Two of the patients had the same molecular abnormalities as well as the same clinical and hematological features as those of Ph-positive CML. The other six patients showed no genomic rearrangement. This group was hematologically divided into four subgroups, namely chronic myelomonocytic leukemia, undifferentiated chronic myeloproliferative disorder, chronic neutrophilic leukemia and CML-like syndrome. This last subgroup resembled Ph-positive CML in many points except for rather moderate proliferation of granulocyte lineage, and it was difficult to clinically separate it from Ph-positive CML.

Elevated serum-soluble interleukin-2 receptor (Tac antigen) levels in chronic myelogenous leukemia patients with blastic crisis

We examined the expression of cell-surface interleukin-2 (IL-2) receptor (Tac antigen) on peripheral blood leukemic cells and measured soluble IL-2 receptor p55(alpha) chain (sIL-2R) levels in sera from chronic myelogenous leukemia (CML) patients with blastic crisis. Flow cytofluorometric analysis performed by dual immunofluorescence in three cases demonstrated coexpression of Tac antigen with myeloid (CD13, CD14, or CD33) or lymphoid (CD10) antigen on significant proportions of peripheral blood leukemic cells. Radiolabeled IL-2-binding assay demonstrated the specific IL-2 binding sites in three cases examined. The exogenous IL-2, however, failed to induce proliferative response. A myeloid cell line, Yut-K3, established from peripheral blood leukemic cells from a CML patient with blastic crisis, also expressed cell-surface Tac antigen and CD13 concurrently. SIL-2R assay showed that Yut-K3 released a detectable amount of sIL-2R in its culture supernatant. The serum sIL-2R levels were significantly elevated (range: 2,580 to 172,000 U/mL) in 12 CML patients with blastic crisis and were slightly elevated in ten patients in chronic phase (range: 250 to 820 U/mL) and in three in accelerated phase (range: 790 to 1,305 U/mL) compared with those in 24 normal controls (range: 70 to 695 U/mL, P less than .01). These results indicated that the leukemic cells from CML patients with blastic crisis expressed and released IL-2 receptor (Tac antigen). Longitudinal studies performed in three cases of CML with blastic crisis showed that the change of serum sIL-2R level was closely associated with that of the number of peripheral blood leukocytes and blasts, the percentage of blasts and serum LDH levels, also suggesting that the serum sIL-2R level is a useful clinical indicator of the leukemic cell burden in vivo.

[Measurement of portal blood flow with magnetic resonance imaging]

A new method for measuring portal blood flow using magnetic resonance imaging has been developed. Flow velocities are calculated from distances that are directly visualized using a new pulse sequence. In a phantom study, the measured flow rates showed a close correlation (r = 0.9996) with actual flow rates in the range 4.7 cm/sec to 22.8 cm/sec. In a study using volunteers, portal blood flow was quickly measured (about 18 seconds) using electrocardiographic gating. These measurements were compared with those obtained by Doppler ultrasound, with which they showed a close correlation in flow velocity (r = 0.968) and flow volume (r = 0.936). This method allows reasonably accurate quantitative analysis of portal blood flow in patients in whom the Doppler method can not be used because of obesity or intestinal gas.

Analysis of hepatofugal flow in portal venous system using ultrasonic Doppler duplex system

Blood flow directions of the portal trunk, splenic vein, and superior mesenteric vein were studied using an ultrasonic Doppler duplex system in 146 healthy adults, 132 patients with liver cirrhosis, 76 with hepatocellular carcinoma, 32 with idiopathic portal hypertension, 134 with chronic hepatitis, 18 with acute hepatitis, and 142 with other diseases. Spontaneous hepatofugal flow in one or more of the three vessels examined was detected in 14 patients. Spontaneous hepatofugal flow in the portal trunk was detected in three patients with liver cirrhosis. In two of these three patients, the hepatofugal flow in the portal trunk disappeared after medication. This is interesting, since hepatofugal flow may, in fact, be more common than we suspected in patients who, because of the severity of their disease, are not able to undergo invasive examination. Postoperative hepatofugal flow in the portal system was detected in 20 of 71 cases: 15/17 patients after interposition mesocaval shunting, 2/17 after distal splenorenal shunting, 2/31 after splenectomy, and 1/6 after splenic artery occlusion with steel coils. In more than half the cases of interposition mesocaval shunting (9/17 patients), blood flow in the portal trunk was hepatofugal. However, hepatopetal blood flow in the portal trunk was maintained in most cases of distal splenorenal shunting (13/17), showing the merits of this technique as a selective portosystemic shunt operation.

Parietal cell autoantigens involved in neonatal thymectomy-induced murine autoimmune gastritis. Studies using monoclonal autoantibodies

Autoimmune gastritis accompanied by autoantibodies to parietal cells was induced in BALB/c nu/+ mice by neonatal thymectomy 2-4 days after birth. Three monoclonal autoantibodies, designated as 2B6 (IgG1), 2G10 (IgG2b), and 1H9 (IgG1), were obtained from one of these mice. All three reacted specifically with parietal cells, 2G10 recognizing species-specific antigenic determinants and 2B6 and 1H9 recognizing interspecies-specific antigenic determinants. All three recognized antigens on the membrane of intracellular secretory canaliculi and the cytoplasmic tubulovesicular system of parietal cells. At least two different molecular groups were recognized by these antibodies; 2B6 recognizing a 65,000-79,000-mol wt group and 1H9 recognizing a 92,000-120,000-mol wt group. Sera of most mice with autoimmune gastritis reacted with either or both groups. Both groups were consistently coprecipitated by any of the three antibodies when solubilized in NP-40. Sera, from patients with pernicious anemia, containing anti-parietal cell antibodies could also precipitate these two groups of antigens. Competition assay and physicochemical studies showed that the epitopes recognized by the three monoclonal antibodies are different.

Effects of dilazep on arachidonic acid metabolism by neutrophils and platelet/neutrophil interactions

The effect of dilazep (tetrahydro-1H-1,4-diazepine-1,4(5H)-dipropanolbis(3,4, 5-trimethoxy-benzoate)dihydrochloride monohydrate, Comelian), a coronary and cerebral vasodilator and an anti-platelet agent, on endogenous and exogenous arachidonic acid (AA) metabolism by human neutrophils and platelet/neutrophil interactions was studied in vitro. Neutrophils preincubated with dilazep (up to 300 mumol/l) were incubated with the Ca ionophore A23187 in the absence or presence of AA. Platelet/neutrophil mixtures preincubated with dilazep (up to 100 mumol/l) were incubated with thrombin plus N-formylmethionylleucylphenylalanine (FMLP), FMLP plus AA, and platelet-activating factor (PAF) plus AA. AA metabolites including leukotriene B4 (LTB4), 5-hydroxyeicosatetraenoic acid (5-HETE) and 5S,12S-dihydroxyeicosatetraenoic acid (5S,12S-DiHETE) were analyzed and quantitated by reversed-phase high-performance liquid chromatography. The formation of LTB4 and 5-HETE from endogenous AA by neutrophils was inhibited by dilazep, whereas their production from exogenous AA was enhanced. LTB4 synthesis from endogenous AA by platelet/neutrophil interactions was inhibited by dilazep, while 5S,12S-DiHETE production was increased. The production of 5-lipoxygenase metabolites from exogenous AA by these interactions was increased by this drug. Thus, dilazep inhibits endogenous AA metabolism by neutrophils and by platelet/neutrophil interactions, whereas it stimulates exogenous AA metabolism by these blood cells and their interactions.

Involvement of c-myc oncogene in lymphoma cell lines with no detectable chromosome rearrangement of band 8q24

Two lymphoma cell lines of B-cell type were established from Japanese patients with diffuse small noncleaved cell lymphoma. Cytogenetic analysis revealed a 14q+ marker chromosome in both cell lines, and a t(8;14)(q24.1;q32.3) seemed most likely to have occurred. The chromosome 8 pair, however, had no abnormalities. Molecular analysis demonstrated c-myc amplification lacking gross rearrangement in one cell line and genetic rearrangement of c-myc at the first intron as well as aberrant sizes of c-myc mRNA in the other cell line. In the latter case, it is possible that a t(8;14)(q24.1;q32.3) was buried in an unrecognized complex translocation. A combination of cytogenetic and molecular studies to determine the precise nature of the 14q32 translocation is discussed.

Comparative characterization of B-lymphoblastoid cell lines in adenosine deaminase deficiency and its heterozygote

B-lymphoblastoid cell lines (LCL) transformed by Epstein-Barr virus (EBV) were established from a patient with severe combined immunodeficiency (SCID) caused by adenosine deaminase (ADA) deficiency, from his mother and from a normal volunteer. ADA activities of the patient's and mother's LCL were about 0.5% and 25% of that of the normal LCL, respectively. Proliferation of these three LCL was related to the ADA activity. The patient's LCL grew well in medium containing fetal bovine serum (FBS), but slowly in medium with the ADA inhibitor 2'-deoxycoformycin-treated FBS, horse serum, or without serum. Proliferation of the patient's LCL was markedly inhibited in serum-free medium containing 2'-deoxyadenosine.

Soluble interleukin-2 receptors in plasma cell dyscrasias

Levels of the soluble form of the interleukin-2 receptor (sIL-2R) were evaluated in the peripheral blood of 69 patients with plasma cell dyscrasias. A close relationship was seen between serum sIL-2R levels and clinical features. Among patients with normal BUN and creatinine levels, the mean (+/- 1SD) level of sIL-2R in 44 patients with multiple myeloma (MM) was higher than that of normal controls (457 +/- 227 U/ml vs 288 +/- 124 U/ml, P = 0.01). The mean level of sIL-2R in eight patients with primary macroglobulinemia was 722 +/- 251 U/ml. In MM, those with active or refractory disease showed a significantly higher mean level of sIL-2R than those in the remission phase (577 +/- 240 U/ml vs 335 +/- 103 U/ml, P = 0.01). There was a negative correlation between sIL-2R and hemoglobin levels in MM patients (r = -0.45, P = 0.01). Five patients with complications of renal insufficiency had elevated levels of sIL-2R. In a longitudinal study of a patient with plasmacytoma and an extremely high sIL2-R level, the sIL-2R level showed a strong relationship with tumor burden. Patients with high sIL-2R levels generally had a poor prognosis than those with normal levels. Thus a high sIL-2R level may be an indicator of a poor prognosis in MM.

[Changes in portal blood flow by intravenous administration of glucagon--the relationship between those changes and the total serum bile acid values in UDCA.GLUCAGON tolerance test]

G30TBA is the total serum bile acid concentration obtained thirty minutes after injection of glucagon in the UDCA.GLUCAGON tolerance test. We have previously reported the usefulness of G30TBA in evaluating liver function. In this paper, changes in the portal blood flow in response to glucagon administration are measured and the relationship between those changes and G30TBA studied. We used an ultrasonic duplex system composed of a B-mode scanner and doppler flow meter of measure portal blood flow after injection of glucagon in thirty seven patients with chronic liver diseases. The results are as follows: The increase in portal blood flow by exogenous glucagon in liver cirrhosis is statistically significantly lower than that in chronic hepatitis. G30TBA in the good-response-to-glucagon group is statistically significantly lower than that in the poor-response group. These results suggest that the effect of glucagon on portal blood flow significantly influences the serum bile acid concentration in the UDCA.GLUCAGON tolerance test.

Expression of cytokine mRNA in leukemic cells from adult T cell leukemia patients

HTLV-I infection of peripheral mature T cells appears to induce the expression of cellular genes including those of some cytokines and their receptors. We examined the expression of interleukin-1 alpha (IL-1 alpha), IL-1 beta, IL-2, IL-3, IL-4 and granulocyte/macrophage colony-stimulating factor (GM-CSF) at the mRNA level in fresh leukemic cells from 20 adult T cell leukemia patients to see whether there is any association between cytokine expression and HTLV-I expression and between their expression and clinical manifestations such as hypercalcemia or neutrophilia. IL-1 alpha, IL-1 beta and IL-3 expression was observed in 3, 7 and 1 of 20 cases examined, respectively. However, there seemed to be no association between IL-1 expression and clinical manifestations. IL-2, IL-4 and GM-CSF mRNA expression was not detected. HTLV-I viral RNA expression was detected only in one case in which IL-3 mRNA was expressed in both peripheral blood and lymph node cells and a relatively high proportion of leukemic cells expressed IL-2 receptor (p55, Tac). Thus, in the present study we could not find any correlation between cytokine expression and HTLV-I expression in peripheral blood fresh leukemic cells except in one unusual case.

Clinical usefulness of dual-label Schilling test for pancreatic exocrine function

The usefulness of the pancreatic dual-label Schilling test as an indirect test of pancreatic exocrine function was evaluated. This dual-label Schilling test was based on the difference of absorption for [58Co]cobalamin bound to hog R protein and [57Co]cobalamin bound to intrinsic factor. In this study, the test was performed in 7 normal subjects, 5 patients with pancreatectomy, 12 patients with chronic pancreatitis, 10 patients with suspicion of chronic pancreatitis, and 13 patients without chronic pancreatitis. The normal lower limit (mean -2 SD) of excretion ratio for [58Co]/[57Co] in 24-h urine was 0.68. Of the 26 patients on whom endoscopic retrograde pancreatography was performed, none of the 9 patients with normal pancreatogram, 4 of the 9 patients with mild to moderate pancreatitic changes in pancreatogram, and 7 of the 8 patients with advanced pancreatitic changes in pancreatogram showed a positive value lower than the ratio of 0.68 in this test. In 28 patients examined with the direct test of pancreatic secretory capacity, 2 of the 13 patients with normal function, 6 of the 9 patients with mild dysfunction, and 5 of the 6 patients with definite dysfunction were positive in this test. The results of the pancreatic dual-label Schilling test significantly correlated with those of a direct test of pancreatic secretory capacity and the findings of pancreatitic changes in pancreatogram (p less than 0.01, chi 2 test). The ratio for [58Co]/[57Co] correlated (r = 0.73) with the maximal bicarbonate concentration in duodenal juice of the direct test of pancreatic secretory capacity. The impairment of bicarbonate output by the pancreas may adversely affect the transfer of cobalamin from R protein to intrinsic factor. It suggested that the pancreatic dual-label Schilling test is useful for detecting not only patients with severe pancreatic insufficiency but also the relatively early stage of chronic pancreatitis with bicarbonate secretory dysfunction of the pancreas.

Amyloid goiter with hypothyroidism

Whereas the microscopic infiltration of the thyroid by amyloid is a common phenomenon, significant enlargement of the gland due to the deposition of amyloid is infrequent. Amyloid goiter usually occurs as one of the unusual manifestations of systemic amyloidosis. The rapid growth associated with local pressure symptoms often suggests malignancy. In spite of the extensive infiltration of the gland by amyloid, thyroid function usually remains euthyroid. We have recently observed an unusual case of multicentric giant lymph node hyperplasia in a patient who developed amyloid goiter with hypothyroidism. The amyloid material was of AA type.

Cooperative effects of gamma-interferon and 1 alpha, 25-dihydroxyvitamin D3 on in vitro differentiation of the blast cells of RAEB and RAEB-T

We added recombinant human gamma-interferon (gamma-IFN) and 1 alpha, 25-dihydroxyvitamin D3 (1 alpha, 25 (OH)2D3) to the bone marrow cells from six patients with RAEB or RAEB-T in liquid suspension cultures. After cultivation for 7 to 9 days, numerical, morphological and functional changes of the cells were assessed. gamma-IFN and 1 alpha, 25 (OH)2D3 additively suppressed cell growth, especially the number of blast cells decreased. The expression of alpha-naphthylbutyrate esterase (NBE) activity appeared to be promoted but that of naphthol AS-D chloroacetate esterase (NAE) activity was apparently suppressed by the addition of gamma-IFN and/or 1 alpha, 25 (OH)2D3. The percentage of NBT reduction-positive cells and latex-phagocytizing cells was only slightly increased by both agents. These results indicate that gamma-IFN and 1 alpha, 25 (OH)2D3 cooperate to induce monocytoid differentiation of the patients' blast cells. Combination therapy with both agents merits further study.

Effects of recombinant G-CSF and GM-CSF on in vitro differentiation of the blast cells of RAEB and RAEB-T

To evaluate the effects of recombinant G-CSF and GM-CSF on RAEB and RAEB-T cells, blast cells from 6 patients were incubated in liquid culture systems with these CSFs for 7 days, and their numerical, morphological and functional changes were assessed. Both CSFs stimulated cell growth, but decreased the proportion of blast cells in 5 of the 6 cases. Karyotypic abnormalities persisted during cultivation in some cases. The CSFs also stimulated the expression of part of the esterase activities, and a positive interaction of both CSFs was seen in part. Although CSFs had no significant effects on the ability of cells to reduce NBT or to phagocytize latex particles, the results indicated that they induce partial differentiation of blast cells. It appears that such pathological cells still retain the capacity to respond to growth factors.

Detection of granulocyte colony-stimulating factor produced by a newly established human hepatoma cell line using a simple bioassay system

A colony-stimulating factor(CSF)-producing tumor cell line (KX-87) was established from a patient with hepatocellular carcinoma and marked granulocytosis. This cell line formed tumors on nude mice in high frequency and the mice revealed marked granulocytosis. In clonogenic assays of human bone marrow cells, KX-87 conditioned medium (CM) supported the formation of colonies mainly consisting of neutrophilic granulocytes but had no burst-promoting activity. The molecular weight of the colony-stimulating activity (CSA) in KX-87CM was estimated about 25,000 daltons by gel filtration and a new bioassay system. In principle, a subline of murine hemopoietic cell line NFS-60 was cloned which was dependent on KX-87CM. Then the growth of this subline was examined by a rapid and sensitive colorimetric tetrazolium assay. From these results, it was concluded that the CSA which KX-87 cell line produced was G-CSF.

Effects of dilazep on cytoplasmic calcium ion concentrations and arachidonic acid metabolism in activated human platelets

The effects of dilazep (tetrahydro-1H-1,4-diazepine-1,4(5H)-dipropanol bis(3,4,5-trimethoxybenzoate)-di-hydrochloride monohydrate, Comelian), a coronary and cerebral vasodilator and an antiplatelet drug, on the cytoplasmic Ca2+ concentration ([Ca2+]i) and arachidonic acid (AA) metabolism in activated human platelets were investigated. [Ca2+]i (free calcium ion concentration) of aequorin-loaded platelets was estimated by using the platelet ionized calcium aggregometer. AA metabolism was studied by the determination of AA metabolites, hydroxyheptadecatrienoic acid and 12-hydroxyeicosatetraenoic acid, using reversed-phase high performance liquid chromatography. When platelets were preincubated with dilazep (0-0.5 mmol/l), the drug inhibited both platelet aggregation and [Ca2+]i elevation induced by thrombin, AA and collagen in a concentration dependent manner, while only aggregation was inhibited after stimulation with the Ca ionophore A23187 (calcimycin). Both influx and release of Ca2+ into platelet cytoplasm induced by thrombin or AA were inhibited by dilazep, while neither of them was affected when induced by A23187. Oral ingestion of dilazep as a 100-mg capsule significantly depressed the [Ca2+]i elevation induced by thrombin, AA and collagen after 3 h. Dilazep inhibited endogenous AA metabolism by platelets induced by thrombin, although it enhanced exogenous one. Thus, dilazep inhibited platelet aggregation induced by any agonists including A23187, while [Ca2+]i elevation was inhibited by the drug only when the receptor-mediated agonist was used. Furthermore, it is suggested that dilazep inhibited AA liberation from platelet membrane phospholipids, leading to reduced production of all endogenous AA metabolites after platelet activation although metabolites of exogenous AA could be increased.

Reproducible establishment of hemopoietic supportive stromal cell lines from murine bone marrow

Stromal cell lines, designated MS-1, -2, -3, -4, -5, -6, and -7 were established by irradiating the adherent cells in long-term bone marrow cultures with 900-rad x-rays. Two of the cell lines, MS-1 and MS-5, have the capacity to support the growth of hemopoietic stem cells (spleen colony-forming cells and granulocyte-macrophage colony-forming cells) for greater than 2 months in vitro. These two cell lines were alkaline phosphatase-, peroxidase-, and factor VIII-negative and positive for periodic acid-Schiff and nonspecific esterase. Extracellular matrix proteins such as fibronectin, laminin, and collagen type I were produced by these two cell lines. Neither MS-1 cell- nor MS-5 cell-conditioned medium supported the growth of hemopoietic stem cells, and hemopoietic stem cells were found preferentially to be under and on MS-1 and MS-5 layers rather than in suspension. Close contact with the MS-1 cell layer or the MS-5 cell layer appears to be essential in maintaining hemopoiesis in vitro. Conditioned media from MS-1 cells and MS-5 cells stimulated granulocyte colony formation from murine bone marrow cells in semisolid culture.

[Preleukemic disorders]

Certain hematopoietic disorders and immunodeficiency states are known to carry a risk of developing acute nonlymphocytic leukemia. In the past some of them have been classified by a variety of terms ranging from refractory anemia to preleukemia, but are currently grouped into a new concept of the myelodysplastic syndromes (MDS). The purpose of this article is to briefly review the updated knowledge of the MDS with emphasis on the clonal origin, natural history and mechanisms of leukemogenesis.

Clinical pharmacology of N4-palmitoyl-1-beta-D-arabinofuranosylcytosine in patients with hematologic malignancies

The pharmacokinetics of oral N4-palmitoyl-1-beta-D-arabinofuranosylcytosine (PLAC), a lipophilic and deaminase-resistant derivative of 1-beta-D-arabinofuranosylcytosine (ara-C), were determined in patients with hematologic malignancies. The concentration of ara-C and 1-beta-D-arabinofuranosyluracil (ara-U), metabolites of PLAC, were measured by radioimmunoassay and gas chromatography-mass spectrometry-mass fragmentography, respectively. The concentration of PLAC was determined by measuring ara-C, which was derived from PLAC by hydrolyzation. In six patients given an oral bolus of PLAC (300 mg/m2), the plasma-disappearance curve of PLAC corresponded to a one-compartment open model, including first-order absorption. The peak plasma level was 22.9 +/- 6.4 ng/ml, and the predicted time to reach the peak level was 2.5 +/- 1.0 h. The elimination half-life was 3.8 +/- 2.7 h. The plasma ara-C level increased slowly to 6.9 ng/ml during the 1st 2-3 h after administration and remained over 1.0 ng/ml for 12 h. Plasma ara-U was detectable for at least 24 h, with a peak concentration of 376 ng/ml at 6 h. Urinary PLAC excretion was below the limit of detection (5 ng/ml) in all cases. Prolonged urinary ara-C and ara-U excretion was detected, but the total recovery rate was low (6.7% in 24 h) and varied between patients. In spite of the lipophilic nature of the drug, the PLAC concentration in the cerebrospinal fluid, measured at 3 or 6 h, was below the limit of detection in all four patients with no meningeal involvement. This study showed low but persistent levels of PLAC in plasma and tissues, with a continuous release of small amounts of ara-C, which demonstrated antitumor activity in patients with hematologic malignancies.

Vacuolated plasma cell: ultrastructural distribution of acid phosphatase and intracellular immunoglobulin

In two cases of vacuolated plasma cells, one of which was associated with primary macroglobulinemia and the other was with kappa-chain Bence Jones multiple myeloma, we examined the immunopathological features of the vacuoles in order to know whether the Ig-secreting system or the lysosomal system is of importance in the process of vacuole formation. Immunofluorescent studies detected no Ig in the vacuoles. Detection of intracellular Ig by immunoelectron microscopic technique revealed that Ig was localized only in a small portion of the vacuoles but not in most vacuoles. Even when Ig was included in the vacuoles, only the contents of the vacuoles were positive for Ig but their demarcating membrane was negative for Ig. In contrast, electron microscopic studies of acid phosphatase activity revealed the presence of its activity in all vacuoles. These findings suggest that the lysosomal system but not the Ig-secreting system may play a major role in vacuolation of these myeloma cells.

Influence of water-immersion stress on synthesis of mucus glycoprotein in the rat gastric mucosa

Gastric mucous cells of rats subjected to water-immersion stress were incubated with [3H]-palmitic acid and [14C]-N-acetylgalactosamine. The peptidyl-tRNA released by gastric polysomes was precipitated with cold ethanol and then the content was determined. A 70% reduction in the peptidyl-tRNA isolated was observed in the stressed rats, as compared with in control rats. The peptide recovered from the peptidyl-tRNA showed 30-50% less [3H]-palmitic acid and [14C]-N-acetylgalactosamine incorporation in the stressed rats than in normal controls. It was thus suggested that translation, acylation and glycosylation of the peptides in the ribosomes of the gastric mucosa were remarkably affected by the stress.

Prognostic implication of sequential bone marrow cultures in the myelodysplastic syndromes

Twenty-five patients with newly-diagnosed myelodysplastic syndromes were studied by the clonal culture method at least three times during the clinical course. Clinical outcomes of the patients were classified into: a stable disease (ten patients); subsequent leukemic transformation (eight patients) and nonleukemic death (seven patients). The growth of the marrow granulocyte-macrophage progenitors (CFU-GM) at the time of diagnosis was significantly related to the survival. In addition, sequential changes in the CFU-GM growth patterns correlated with the different clinical outcome of myelodysplastic syndromes patients.

Cytogenetic studies on the adult T-cell leukemia in Japan

Cytogenetic studies were performed on 16 patients with ATL seen in Northern Kyushu island; nine were patients with acute type leukemia, one with crisis type and five with lymphoma type. The serum antibody for HTLV-1 (ATLA) was positive in all patients and the phenotype of ATL cells were ERFC+, OKT3+, OKT4+, OKT6-, OKT8-, OKT10+, OKla1+/- and Tac+. Abnormal findings of chromosomes were observed in 15 patients. Thirteen patients were in near diploid range. One patient was in triploid range and one patient was in tetraploid range. The polyploid karyotypes were found only in lymphoma type patients. Trisomy 3 and trisomy 7 were observed each in three patients with acute type of ATL. The most frequent abnormal rearrangement was observed in the long arm of chromosome 6 and the break occurred at band 6q15 and 6q21 each in four patients in this series.

Lysis of human leukemic cells by monocyte-derived macrophages activated with interferon-gamma and interleukin-2

Cytolysis of leukemic cells by peripheral blood-derived macrophages was examined by means of an in vitro 111In release assay. Monocytes prepared on culture dishes lyse YK-M2. However, when monocytes were cultured in vitro and transformed into macrophages, they lost most of their lytic activity. The addition of human recombinant interleukin-2 (rIL-2) on day 5 in culture enhanced the lytic activity significantly. Similarly, treatment of macrophages with human recombinant interferon gamma (rIFN-gamma) promoted the lysis of YK-M2 and K-562, although the extent of lysis was smaller than that by rIL-2. Macrophages activated with rIL-2 and rIFN-gamma also lysed human leukemic cells. Activated macrophages lysed leukemic cells of acute myelocytic leukemia more than acute lymphocytic leukemia cells. Macrophages derived from the peripheral blood of patients with leukemia were examined for their lytic activity against YK-M2. The patient's macrophages lysed more YK-M2 than did control macrophages when they were activated with rIL-2 and rIFN-gamma. The macrophages of two patients also demonstrated autologous leukemic cell lysis.

Effect of immunoglobulin preparation on course of AIDS-related complex (ARC)

Relatively low dose treatment (150 mg/kg, once per two weeks) of a intravenous immunoglobulin (IVI) preparation has shown a beneficial effect on CD4/CD8 ratio and CD4 cell counts in two patients with AIDS-related complex (ARC). Since ARC generally progresses to AIDS with a marked reduction of CD4 cells or a marked inversion of CD4/CD8 ratio, this type of IVI treatment seems to be effective for obstructing or at least delaying the progression from ARC to AIDS.

Restriction fragment length polymorphism of bcr in Japanese patients with hematological malignancies

We surveyed DNAs from patients with various hematological malignancies by Southern blot hybridization to analyze bcr rearrangements, and detected a new restriction fragment length polymorphism (RFLP) of the breakpoint cluster region at a BamHI site in three patients. By using a 1.2-kb HindIII-BglII 3' bcr probe, unusual BamHI restriction enzyme fragments (1.9 kb and 1.4 kb) were detected from the DNAs of three patients with hematological malignancies. DNAs from cultured fibroblasts derived from the skin of a patient, as well as from peripheral leukocytes of the father of a patient and the mother of another patient, showed identical 1.9- and 1.4-kb additional bands, besides a 3.3-kb germline band, establishing that polymorphism, rather than gene arrangement, was responsible for these additional restriction enzyme fragments. However, RFLP was not detected in the DNAs of 40 normal unrelated individuals.

Leukemic cells from a chronic T-lymphocytic leukemia patient proliferated in response to both interleukin-2 and interleukin-4 without prior stimulation and produced interleukin-2 mRNA with stimulation

Recently, interleukin-4 (IL-4) has been clarified as having T-cell growth factor activity; therefore, it becomes of interest whether IL-4, as well as interleukin-2 (IL-2), affects the proliferation of leukemic cells derived from mature T cells. In the present study, we describe a case of chronic T-lymphocytic leukemia (T-CLL) with monoclonal proliferation of human T-lymphotropic retrovirus (HTLV)-I or HTLV-II negative CD3(+)4(+)8(-) T cell expressing IL-2 receptors without stimulation. Radiolabeled IL-2 binding assay revealed 750 high-affinity and 6,750 low-affinity binding sites per cell. In accordance with the expression of high-affinity IL-2 receptors, the leukemic cells proliferated in response to exogenous IL-2 without prior stimulation. In addition, exogenous IL-4 also induced their proliferation. Moreover, IL-2 and IL-4 exerted a synergistic effect on the leukemic cell proliferation. Although the expression of IL-2 or IL-4 mRNA was not detected in fresh leukemic cells, the expression of IL-2 mRNA, but not IL-4 mRNA, was induced by phytohemagglutinin stimulation, and the leukemic cells proliferated. These findings suggest that not only IL-2, but also IL-4 are involved in the proliferation of leukemic cells of T-CLL.

Malignant histiocytosis with rearrangement of the heavy chain gene and evidence of monocyte-macrophage lineage

A unique case of malignant histiocytosis (MH) is reported. Its origin from the monocyte-macrophage system was indicated by expression of highly specific myeloid cell markers (My4, MCS2, and cytoplasmic lysozyme), diffuse activity of acid phosphatase and NaF-sensitive alpha-naphthyl acetate esterase, lack of immunologic markers specific for other cell lineages, and germ line configuration of the immunoglobulin light chain gene and the T-cell receptor beta-chain gene. Its neoplastic nature was suggested by the single rearranged band of the immunoglobulin heavy chain gene.

Leukemic cells from some adult T-cell leukemia patients proliferate in response to interleukin-4

The proliferative response of fresh peripheral blood leukemic cells from eight adult T cell leukemia (ATL) patients to interleukin-4 (IL-4) was studied to determine the possibility that the IL-4-mediated T-cell growth pathway is involved in the cell growth of leukemic cells in ATL. Resting lymphocytes from ten normal individuals did not proliferate in response to IL-4. Leukemic cells from two ATL patients did not respond to interleukin-2 (IL-2) or IL-4. Leukemic cells from two patients did respond to IL-2, but not to IL-4. In contrast, a strong proliferative response was observed in the IL-4 culture, but not in the IL-2 culture in the remaining four patients. Chromosome analysis of mitotic cells, performed in one of four patients, confirmed that the cells dividing in response to IL-4 were leukemic cells, but not activated normal lymphocytes. These results indicate the activation of IL-4/IL-4 receptor system in leukemic cells from some ATL patients and suggest the possible involvement of the system in the proliferation of leukemic cells and the leukemogenesis in ATL.

Establishment of a peripheral T-cell lymphoma cell line showing amplification of the c-myc oncogene

A new T-cell lymphoma cell line, designated T34, was established from freshly isolated lymph node tumor cells of a patient with non-Hodgkin's diffuse large cell lymphoma. The T34 cells, as well as the parental lymphoma cells, showed mature helper/inducer immunophenotypes in that they formed spontaneous sheep erythrocyte rosettes and reacted with OKT-3 and OKT-4 monoclonal antibodies. They were negative for OKT-6, OKT-8, terminal deoxynucleotidyl transferase, WT-1, and HLA-DR antigens. Molecular analysis revealed that the T34 cells contained 8- to 16-fold amplified c-myc DNA. The same genetic change was observed in parental lymphoma cells, indicating that the c-myc amplification had occurred in vivo. There was no gross rearrangement of the c-myc DNA. The c-myc gene of the T34 cell line was actively transcribed into normal-sized c-myc mRNA. Cytogenetic analysis showed that both the T34 and the parental lymphoma cells had a near-triploid karyotype with multiple structural chromosome changes. The terminal end of the long arm of chromosome No. 8, the chromosomal locus of single-copy c-myc, was elongated (8q+ chromosome), perhaps reflecting the site of c-myc amplification. These data suggested that amplification of the c-myc oncogene played some role in progression and proliferation of this peripheral T-cell neoplasm.

Soluble interleukin-2 receptors in the serum of patients with chronic renal failure

The levels of soluble form of the interleukin-2 receptor (sIL-2R) were evaluated in the peripheral blood of 29 patients with chronic renal failure (CRF) using enzyme-linked immunosorbent assay. All patients had undergone hemodialysis and the mean (+/- S.D.) BUN was before hemodialysis was 80.9 +/- 22.4 mg/100 ml. The mean level of sIL-2R was 1146 +/- 258 U/ml, which was significantly higher than the level (288 +/- 118 U/ml) in 12 individuals with a normal BUN level (p = 0.01). In patients with CRF, the elevated sIL-2R level was not influenced by hemodialysis, and not correlated with creatinine or beta 2-microglobulin levels. The kidneys may play an important role in the catabolism of serum sIL-2R. The elevated sIL-2R level may be related to compromised immunoregulation in CRF.