Granulocyte antibodies in leukaemic chronic lymphoproliferative disorders

Abstract

The anti-granulocyte activity of serum from patients with B-cell chronic lymphocytic leukaemia (CLL) and other lymphoproliferative disorders was investigated. Granulocyte-binding IgG was measured in 34 patients with CLL, 13 patients with hairy cell leukaemia, one patient with prolymphocytic leukaemia, two patients with Sézary cell leukaemia, and seven patients with chronic T-cell lymphocytosis who had a predominance of circulating large granular lymphocytes. Anti-granulocyte activity was absent in CLL and its variants, but present in the majority of granulocytopenic patients with chronic T-cell lymphocytosis. In one of these patients, granulocytopenia was associated with complement-activating IgG granulocyte antibody. Thus, antibody-mediated granulocyte injury appears to be an unusual occurrence in chronic lymphocytic leukaemia, but is a frequent complication of chronic T-cell lymphocytosis.

Pathophysiologic mechanisms and management of neutropenia associated with large granular lymphocytic leukemia

“…Several studies have indicated the presence of antineutrophil antibodies in the sera of some patients with LGL leukemia and neutropenia [57,59,[60][61][62]. However, in most of these cases, the possibility that the detected antibodies were anti-HLA antibodies, rather than true neutrophil autoantibodies, was not properly addressed [27,28].…”

“…In addition, circulating immune complexes, which are more often present in the serum of patients with LGL leukemia, may limit the ability of certain tests to identify specific neutrophil autoantibodies [27,28]. To distinguish between neutrophil antibodies and HLA alloantibodies, a study was undertaken in five patients with T-LGL leukemia [62]. Using a battery of assays, the authors found low levels of immune complexes in only one patient and no definitive neutrophil autoantibodies in the remaining four patients.…”

Autoimmune Pancreatitis and Concurrent Small Lymphocytic Lymphoma: Not Just a Coincidence?

“…It has long been documented that CLL-SLL is often associated with autoimmune phenomena, 23 most notably autoimmune hemolytic anemia (AIHA) and thrombocytopenia (AITP), 24,25 neutropenia, 26 and, rarely, pure red cell aplasia. 27 Barcellini et al studied 194 cases of autoimmune complications in CLL patients and found 30 other autoimmune diseases in addition to AIHA and AITP.…”

Treatment of chronic neutropenia associated with large granular lymphocytosis with cyclosporine a and filgrastim

“…A "maturation arrest" of the myeloid series and lymphocytic infiltration is observed in the bone marrow of most patients [2]. Some studies have demonstrated antineutrophil antibodies and decreased neutrophil survival, but the etiology of the neutropenia is not clearly understood [7]. Although many patients are stable clinically for extended periods of time, a proportion eventually require therapy for cytopenias and associated recurrent bacterial infections [S-lo].…”