Combined studies of direct membrane immunofluorescence with anti-immunoglobulin serum and of lymphocyte blastogenic responses to autologous leukemia cells were carried out in 34 adult patients with acute leukemia. Twenty-four of 34 (71 per cent) has positive blastogenic responses to their own leukemia cells. Eight of 19 patients with acute myelogenous leukemia and one of five with acute lymphoblastic leukemia had complete or partial abrogation of this positive blastogenesis when the lymphocytes were cultured in autologous rather than allogeneic serum. Direct membrane immunofluorescence with anti-immunoglobulin serum showed bound IgG on the cells of seven of eight patients with acute myelogenous leukemia and serum inhibition, and one without the serum inhibitory effect. Membrane immunofluorescence was negative in two patients with positive blastogenesis and serum inhibition, 14 of 15 with positive blastogenesis and no serum inhibition and, finally, all 10 patients with negative blastogenic responses to leukemia cells. A good prognosis was correlated with a positive blastogenic response, its inhibition by autologous serum, and IgG bound to the cell surface. DURING the past several years there has been increasing evidence that tumor-associated antigens are present in a variety of human neoplasms,12 including acute leukemia. In studying the immunologic response to human leukemia, Yoshida and Imai found that the serum of 71 per cent of patients with acute leukemia gave a positive immune adherence reaction with autologous leukemia cells.3 In contrast, using similar methods, Doré et al. observed that only 22 per cent of 140 patients with acute leukemia had evidence of antibody directed against autologous leukemia cells.4 Cell-mediated immunity was observed by Oren and Herberman, who reported that the majority.
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