Neutrophil chemotaxis and random migration in acute lymphoblastic leukaemia of childhood. Cellular and humoral aspects.

Abstract

SUMMARY The cellular and humoral components of the neutrophil chemotactic response were studied in 65 children with acute lymphoblastic leukaemia (ALL). An abnormality in both components was found during relapse. In remission the cellular component only was affected. Although less obvious than during relapse the abnormality persisted while all cytotoxic therapy was given, returning to normal several weeks after treatment had been stopped. The absence of significant infection in relapse in this series could be due to the fact that a remission was achieved within 3 weeks in all patients. However, a positive correlation between the migration index and incidence of bacterial infection during remission stressed the importance of impaired neutrophil chemotaxis in ALL.The type of infecting organism has changed with more aggressive treatment of leukaemia, but bacterial infection remains a major problem and cause of death.'-2 Although severe granulocytopenia correlates reasonably well with susceptibility to infection,3-5 some patients may have severe and recurrent infective episodes despite adequate levels of circulating neutrophils. Certain aspects of neutrophil function-namely, phagocytosis and intracellular digestion-have been studied in leukaemia and found to be normal by some workers36 but other workers, using different methods, have shown a distinct decrease in these functions.7-9 Thompson and Williams10 demonstrated that 36 % of leukaemic children in relapse and 25 % of those in remission had depression of the intracellular digestive capacity of neutrophils, and in these children the clinical incidence of infection was greatest. In order to see if an earlier phase in neutrophil function was affected we studied cellular and humoral aspects of neutrophil chemotaxis and random migration. Tests were done in relapse and remission at different stages of the diseases, both on and off treatment. Materials and methods65 children with acute lymphoblastic leukaemia (ALL) were studied, the values obtained were compared with those of age matched controls. The cellular aspects of chemotaxis was studied in 52 children. Six were in relapse (4 at diagnosis and 2 at the time of the first relapse, off all treatment); the other 46 children were in remission at the time of the study. 30 were studied on 39 occasions (7 tested more than once) while on maintenance therapy (10 had had treatment for <3 months, 6 for 3-6 months, 8 for 7-12 months, 8 for 13-24 months, and 7 for 25-36 months). All these children were included in MRC treatment trials (UKALL

Neutrophil function in children with acute lymphoblastic leukaemia in the presence and absence of viral infections.

“…Baehner et al (1973) found a temporary bactericidal defect associated with craniospinal irradiation, but not at any other time in remission. Sarab-el-Nakeeb and Thompson (1977) reported abnormal chemotaxis in children with ALL in remission. Bactericidal defects have also been described during relapse ofALL (Strauss et al, 1970;Humbert et al, 1976).…”