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At least 19 recordsLinked to original sources

Restoration of immunocompetency by lymphocyte transfusion.

A female patient with metastatic osteosarcoma was given a lymphocyte transfusion from her brother, cured of the same histologic type of tumor ten years earlier. Prior to the transfusion the patient was anergic. Following lymphocyte transfer cutaneous reactivity to DNCB was restored. Skin reactivity to mumps and varidase antigens was specifically transferred. Whole lymphocyte transfer is a feasible method for restoring immune competence in the anergic cancer patient.

Adolescent

Clinical and immunological restoration in patients with AIDS after marrow transplantation, using lymphocyte transfusions from the marrow donor.

The diagnosis of transfusion-associated acquired immunodeficiency syndrome (AIDS) was made in 2 patients who developed delayed opportunistic infections and severe cytopenias--56 months for the former (patient 1) and 22 months for the latter, (patient 2) following bone marrow transplantation (BMT) for aplastic anemia. In the third case, grafting for acute leukemia (patient 3) (HIV) infection was probably responsible for the failure of hematological and immunological reconstitution 8 months after allogeneic BMT. Each patient received 6 lymphocyte transfusions from the marrow donor for 3 weeks, combined with a 3-month course of low-dose recombinant alpha interferon. This treatment was followed by recombinant gamma interferon for 3 months. We showed that these 3 patients could resume a normal life for 9 months, at least, and that hematological restoration was observed. Our treatment succeeded in correcting the defect of proliferative response to Candida and the impairment of gamma interferon generation for 4 months in one patient and for more than 12 months in the other two recipients. Nevertheless T4 lymphocyte levels increased only slightly and HIV can still be isolated from the patients' blood. At the time of writing, patients 1 and 3 remain in good health with a partial immunological restoration while patient 2 has died of neurological impairment 2 years after the AIDS diagnosis. Although we cannot generalize this successful therapeutic approach to all patients with AIDS, the results may provide an interesting model of the potential effect of lymphocyte transfusions and the role of interferon therapy.

Acquired Immunodeficiency Syndrome

Hypothesis: blocking factors and human pregnancy: an alternative explanation for the success of lymphocyte transfusion therapy in abortion-prone women.

Recent evidence has demonstrated that the non-specific immunosuppression that develops during pregnancy is not due to the de novo synthesis of immunosuppressive factors (ISF) but is a result of the activation of pre-existing molecules. The latter are present in normal sera as inactive complexes with a molecule which is specifically depleted following conception resulting in the activation of the ISF; the depleted molecule is termed the pregnancy-depleted immunoregulatory factor (pdIRF). Since non-specific ISF are detected in various diseases, it is proposed that the ISF-pdIRF relationship observed in pregnancy is a universal phenomenon and that the depletion of pdIRF and the activation of ISF can be achieved by a variety of stimuli. It is further proposed that abortion-prone women fail to adequately deplete their pdIRF levels so that the ISF are not activated. However, owing to the universal nature of the system, lymphocyte transfusion therapy supplies the necessary stimuli so that the pdIRF levels are depleted and the ISF activated which ensures a successful outcome to the pregnancy.

Abortion, Habitual

Studies on the leukocytosis and lymphocytosis induced by Bordetella pertussis. 3. The distribution of transfused lymphocytes in pertussis-treated and normal mice.

Peripheral blood lymphocytes were isolated from normal mice and mice undergoing pertussis-induced lymphocytosis. After labeling in vitro with tritiated uridine the cells were transfused into normal or pertussis-treated mice. It was found that the lymphocytes from pertussis-treated mice entered the lymph nodes of both normal mice and pertussis-treated mice to a significantly lesser extent than did normal lymphocytes which had been transfused into either class of recipient. In addition, an interdependence of changes in the various body compartments examined was found when normal lymphocytes were injected into either type of recipient. However, when pertussis lymphocytes were injected into normal mice there was no interrelationship between the changes in the node with those in the blood, liver, lung, or spleen. In the case of pertussis lymphocytes transfused into pertussis-treated mice no interrelationship between any two compartments was observed. It was concluded that in pertussis-treated mice there is an inhibition of lymphocyte emigration which is primarily the consequence of an effect on the cell.

Animals

Lymphocyte transfusion in recent onset type I diabetes mellitus--a one-year follow-up of cell-mediated anti-islet cytotoxicity and C-peptide secretion.

In 19 patients with newly diagnosed Type I diabetes mellitus a single transfusion of 1.9 x 10(9) to 1.5 x 10(10) lymphocytes was performed. Fifteen Type I diabetic patients who did not receive a transfusion were used as controls. Anti-beta-cell cell-mediated cytotoxicity was measured using an insulin release assay. Stimulated C-peptide secretion (100 g glucose orally, 1 mg glucagon i.v.) was used to estimate residual beta-cell function. Both parameters were measured prior to transfusion and after 12 months. The transfusions were followed by a fall of cytotoxicity below the 95% confidence limit of the controls in 11 of the 19 patients ('responders') (15.7 +/- 1.7 ng insulin/islet/20 h vs 6.7 +/- 1.3 P less than 0.001), while the other eight transfused patients ('non-responders') (13.5 +/- 1.9 vs 17.1 +/- 2.9, ns) and the non-transfused control patients (11.6 +/- 1.1 vs 14.2 +/- 2.4, ns) displayed persistently high cytotoxicity levels. In the responder group a slight improvement in stimulated C-peptide secretion was observed (136 +/- 43 pmol/dl vs 148 +/- 38, ns) whereas in the non-responder (127 +/- 28 vs 106 +/- 25, ns) and in the control group (130 +/- 17 vs 97 +/- 19, P less than 0.05) the stimulated C-peptide responses declined during the 12-month follow-up. Thus, lymphocyte transfusion may have beneficial effects by suppressing anti-beta-cell cytotoxicity and preserving C-peptide secretion.

Adolescent

The effect of neuraminidase on the fate of transfused lymphocytes.

Evidence has been obtained that incubation of rat lymphocytes with neuraminidase, prior to intravenous transfusion into allogeneic or syngeneic recipients, alters the distribution of the cells. Many enzyme-treated lymphocytes initially become trapped in the liver, and there is a decrease in the selective accumulation of these cells in the lymph nodes and spleen. Subsequently, many enzyme-altered cells emigrate from the liver, concentrate in lymph nodes, and recirculate to the lymph. The results suggest that sialic acid constituents of the lymphocyte surface play a critical role in ensuring the normal distribution of these cells in the body. The findings also imply that reactions involving surface sialic acid can markedly alter the fate of lymphocytes without "killing" the cells.

Agglutination

Passive transfer of immunity into leprosy patients by transfusion of lymphocytes and by transfusion of Lawrence's transfer factor.

About 1,200 million viable lymphocytes from normal but lepromin- and tuberculin-positive human beings were transfused in four patients of lepromatous and one of tuberculoid leprosy three times at monthly intervals. Three patients of lepromatous leprosy suffered from erythema modosum, whereas the other two developed severe reaction whenever put on the smallest dose of dapsone. In one patient of lepromatous leprosy, minimal improvement or none was observed, whereas in the remaining three cases of lepromatous and one of tuberculoid leprosy, clinical, bacteriological, as well as histological improvement occurred. Two of the five patients started to tolerate the dapsone during the period of study. The present study indicates that immunotherapy might have a definite role in the management of the disease especially in cases with erythema nodosum. Lawrence factor, prepared from leucocytes of normal donors, was transfused three times into four lepromatous leprosy patients who were intolerant to anti-leprosy drugs. The donors were healthy but were tuberculin and lepromin (Mitsuda) positive. The clinical, histological, bacteriological (morphological index), and immunological assessments of the patients were performed before and 5 months after starting the immunotherapy. In two patients conversion of Mitsuda reaction occurred, but there was no appreciable improvement in the clinical, histologic, and bacteriologic status of these patients.

Adolescent

Lymphocyte subpopulations in long-term dialysis patients: a case-controlled study of the effects of blood transfusion.

Lymphocyte subsets in a group of intensely transfused (greater than 10 units/year) patients on long-term hemodialysis were compared with those in a carefully controlled population of lightly transfused (1-10 units/year, no units during study period) long-term dialysis patients. The data confirm previous reports of lymphopenia and a symmetrical reduction of both T- and B-cell subpopulations in patients on long-term dialysis. Eleven (36.7%) of 30 intensely transfused dialysis (ITD) patients had a low T8 population when expressed as a percentage value, while 0 of 25 lightly transfused dialysis (LTD) control patients exhibited a low percentage of T8 cells. There were no significant absolute differences between the lymphocyte subsets in the ITD and LTD patients. These data contrast with previous reports of other groups of ITD patients in whom there was an observed increase in T8 cytotoxic suppressor cells. Our findings suggest that the immunologic effects of renal failure and long-term dialysis largely override the increase in T8 lymphocyte subsets observed in other groups of transfused patients. There is little difference between ITD and LTD patients, but both groups are significantly different from nontransfused controls. Further longitudinal studies are needed in completely untransfused patients to resolve the contribution of minimal transfusion therapy to the immunologic deficits observed in long-term dialysis patients.

Adolescent