Suppression of mitogen- and alloantigen-induced proliferation by chronic lymphocytic leukemia cells of T-cell origin

Large granular lymphocyte (LGL) lymphoproliferative diseases: naturally cytotoxic tumors in man and experimental animals

It has recently become clear that in the spleen and blood of both rodents and man that a unique subpopulation of lymphocyte is the mediator of virtually all of the inherent natural killer (NK) and antibody-dependent cell-mediated cytotoxic (ADCC) activity. Because of their large size, eccentric kidney-shaped nucleus and prominent cytoplasmic granules, these cytotoxic cells, termed large granular lymphocytes (LGL), can be readily identified in Geimsa stained cytocentrafuge preparations. Unfortunately, the relatively low numbers of these cells in normal lymphoid tissues has made the detailed analysis of LGL quite difficult. Recently however, a number of investigators have reported both rodent and human leukemias or leukocytosis in which there was an abnormally high number of circulating lymphocytes with either the appearance and/or function of LGL. The present manuscript reviews this literature with an emphasis on the biological and clinical characteristics of this lymphoproliferative disease. Emphasis is also placed on the usefulness of these cells for the detailed analysis of LGL morphology and function.

Functional diversity within the suppressor phenotype as defined by monoclonal antibody in T-cell prolymphocytic leukemia

A patient with T-cell prolymphocytic leukemia (T-PLL) is described. The malignant T-cells from the patient were predominantly Leu-2-positive, indicating a suppressor phenotype. The cells were then tested to determine their functional capabilities. The patient's Leu-2-positive cells initially suppressed B-cell proliferation, as predicted by their phenotype but later functioned as T helper cells in the pokeweed mitogen system without a change in phenotype. The cells also responded inadequately to alloantigen and mitogen despite addition of exogenous T-cell growth factor (TCGF). Leu-2-positive prolymphocytes from the spleen of the patient were constitutive producers of TCGF. Surface phenotype using monoclonal antibody was inadequate to predict T-cell function of the cells from this patient with T-PLL. In addition, these data suggest there may be functional subpopulations within the OKT8+ phenotype. Constitutive TCGF production by malignant post-thymic T-cells may represent a mechanism by which these cells sustain their own growth.

Phenotypic and functional characterization of HTLV positive neoplastic T cells cultured with interleukin-2--II. Inhibition of lymphoproliferative responses

T cells from the peripheral blood of a T-cell chronic lymphocytic leukemia (T-CLL) patients, were expanded by culture in the presence of interleukin-2 (IL-2). In contrast to the original leukemic T cells that showed a complete lack of suppressor activity, the proliferating T-CLL cells were extremely potent inhibitors of mitogen, antigen and alloantigen induced lymphoproliferative responses. Compared to the fresh T-CLL cells, the proliferating T-CLL cells showed an enhanced expression of the human T-cell leukemia/lymphoma virus (HTLV) p19 antigen and released type C virus particles into their culture supernatant. A direct involvement of the virus particles in the suppression was however unlikely, since the inhibition was found to be mediated by a soluble inhibitor in the culture supernatant of proliferating T-CLL cells. This inhibitor was very hydrophobic and was inactivated by treatment with trypsin, by heating to 56 degrees C for 2 h and by storage at -70 degrees C for more than 14 weeks. It could be excluded that the suppression of lymphoproliferation was due to competition for IL-2, to toxic effects, to nutrient depletion or to a shift in the kinetics of the target cell responses. Furthermore, it could not be attributed to suppressor inducer activity of the OKT4+ proliferating T-CLL cells, since normal T cells enriched for OKT4+ T cells and depleted for OKT8+ T cells were also inhibited in their proliferation. Since other hemopoietic cell lines, not of OKT4+ T lymphocyte origin, also were suppressed to proliferate, it is concluded that the proliferating T-CLL cells represent a neoplastic T-cell clone that had differentiated into suppressor effector T cells after prolonged culture in the presence of IL-2.

Adult T-cell lymphoma leukemia in Western countries

A new T-cell disorder has recently emerged: the so-called adult T-cell lymphoma leukemia (ATLL) initially described in Japan. Subsequently, ATLL cases were recognized in patients from the Caribbean. We summarize the clinical and hematological features of 19 published cases from Western countries, in addition to a new case we encountered. The leukemic cells display characteristic morphological features and a T3+T4+T8-T6- surface antigenic phenotype. Overall survival is of short duration, but remission could be obtained in our case despite a subsequent relapse in skin and CNS. Geographic clusters of ATLL cases have led to the discovery of the possible role of a new retrovirus, HTLV, in the genesis of this rare malignancy.

B-cell function in patients with chronic lymphocytic leukemia

Using a reverse hemolytic protein A plaque assay, spontaneous and pokeweed mitogen (PWM)-induced immunoglobulin (Ig) secretion was determined in peripheral blood from 22 patients with B1-chronic lymphocytic leukemia (CLL), one patient with B2-CLL, and one patient with suppressor T-CLL. Diagnoses were established by cytological and histological criteria as well as several marker analyses. Lymphocytes from B1- and B2-CLL patients were unable to secrete Ig either spontaneously or after PWM stimulation. In T-CLL lymphocytes, spontaneous Ig secretion was suppressed very probably by the OKT-8-positive leukemic population, since, after cultivation with PWM, a normal Ig secretion could be demonstrated which was paralleled by a decrease in the OKT-8-positive cells. Cocultivation experiments with freshly isolated, unseparated lymphocytes from normal subjects and lymphocytes from patients were of no informational value, since isolated normal B-cells alone already showed a high rate of Ig secretion. However, coculture experiments with separated subpopulations after PWM stimulation revealed an intrinsic B-cell defect in lymphocytes from B1-CLL patients, whereas their T-lymphocytes were found to be normal helper cells.

Activation of leukemic pro-suppressor cells to become suppressor-effector cells. Influence of cooperating normal T cells

We studied the suppressor activity and surface-membrane antigens of immunoregulatory neoplastic T cells from a child with acute lymphoblastic leukemia and hypogammaglobulinemia. The neoplastic T cells were potent inhibitors of immunoglobulin production by pokeweed-mitogen-stimulated normal B cells when radiosensitive cooperative normal T cells were present. Preculturing the leukemic cells with normal T cells or soluble factors allowed them to mediate suppression without the need for cooperating T cells. While acquiring new functional capabilities, approximately 95 per cent of the leukemic cells displayed an antigen (OKT-3) that is found on mature normal T cells; 77 per cent displayed an antigen (Tac) that is found on normal activated immunoregulatory effector cells but not on thymocytes or circulating T cells that are precursors of these effector cells. The results suggest that a population of leukemic prosuppressor cells can be induced to undergo both functional and antigenic differentiation by the influence of normal T cells.