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RHEUMATOID-FACTOR-LIKE GLOBULINS AND TROPICAL PARASITIC INFECTIONS
1266 factor in leukxmic plasma (including A.L.L.) mitotic activity in normal leucocytes in vitro. a
capable
of
inducing
conclusion, this work shows that peripheral-blood lymphocytes from A.L.L. and from C.L.L. behave in a definitely different way in respect of P.H.A. stimulation, perhaps because immune reactions are well preserved in acute leukaemia, whereas in C.L.L. they are impaired." In
The Blood Research Foundation Centre of Tortona is supported The Blood Research Foundation, Washington, D.C., U.S.A.
by
Department of Pediatrics G. Gaslini, University of Genoa, and Blood Research Foundation Centre, Municipal Hospital of Tortona, Italy.
G. L. R. P.
ASTALDI MASSIMO AIRÒ G. MORI.
RHEUMATOID-FACTOR-LIKE GLOBULINS AND TROPICAL PARASITIC INFECTIONS
Fig. 1-Percentages of blast-like cells obtained in tissue culture with P.H.A. from peripheral-blood lymphocytes in a group of cases of acute lymphatic leukaemia and in control groups (healthy children and chronic lymphocytic leukaemia). On the other
hand,
under the
same
experimental conditions,
the
peripheral-blood lymphocytes from healthy children in cultures with P.H.A. gave percentages of 63-3 ±6-6. The blast-like cells deriving from A.L.L. peripheral blood presented the same morphology as the blasts obtained with P.H.A. stimulation of lymphocytes from healthy persons (fig. 2). It remains to be established whether only the native small (mature) lymphocytes react to P.H.A. stimulation, or whether native immature cells (leukæmic lymphoblasts) react to it, and thus contribute to the final number of blast-like cells observed in cultures with added P.H.A. The fact that in the control cultures (without P.H.A.) the cell population after 3 days of incubation consisted chiefly of small lymphocytes (93%) may suggest that the blast-like cells are derived mostly from small lymphocytes. Secondly, in P.H.A.-stimulated cultures of lymphocytes from healthy children, to which A.L.L. plasma was added, the percentage
SIR,-Dr. Houba and Dr. Allison (April 16) write that rheumatoid-factor-like globulins seem to be a relatively common finding among Africans, although classical rheumatoid arthritis is apparently rare, and that " Africans are subject to many chronic infections, several of which might lead to formation of rheumatoid-factor-like globulins ". They found that the prevalence of rheumatoid-factor-like globulins in subjects from a malarial region in Kenya was higher than in subjects from a non-malarial region in the same country. Some years ago I12 found positive sensitised sheep-cell agglutination tests (S.S.C.A.T.) in 3 of 4 marines with Plasmodium vivax infections who had recently returned to the Netherlands from New Guinea. One or two months after discontinuance of proguanil prophylaxis they had a delayed primary attack of vivax malaria. During the active phase of this infection 3 patients showed an abnormally high S.S.C.A.T. titre (normal < 1/32), which dropped to normal some weeks after therapy had been instituted, as follows:
These observations give direct evidence that P. vivax infections can play a part in the origin of rheumatoid-factor-like
globulins. University Department of Medicine, St. Radboud Hospital, Nijmegen, Netherlands.
J. H. M. VAN TONGEREN.
DEHYDROEMETINE IN CHRONIC LEUKÆMIA SIR,-I was interested in Dr. Abd-Rabbo’s letter (May 21) describing the beneficial effect of dehydroemetine (D.H.E.) in a case of aleukæmic myeloid leukaemia in which the marrow picture returned to normal after treatment with this drug. I have also used the drug in a number of cases of malignant disease. of 75 years developed congestive heart-failure and bloody anal discharge. Sigmoidoscopy disclosed a bleeding annular carcinoma about 2 in. in breadth completely encircling the bowel about 3 in. above the anus. Biopsy on three occasions showed adenocarcinoma. She was unfit for surgical resection and she steadfastly refused to submit to radiotherapy. She was treated by two courses of 10 daily intramuscular injections of 60 mg. of D.H.E. with an interval of ten days between them. The anal bleeding ceased after the first course. At the end of a month sigmoidoscopy was repeated and no sign of the growth was present. Biopsies revealed only normal epithelium. She was followed for two years and repeated sigmoidoscopies were carried out, but no evidence of recurrence of the growth was found. She died recently of congestive heart-failure, and at necropsy no evidence of cancer was made out even in microscopic sections of the originally affected area. 11. Libansky, J. Blood, 1965, 25, 169. 12. van Tongeren, J. H. M. Ned. Tijdschr. Geneesk. 1962, 106, 1017.
A also
Fig. 2-Above: blood-picture before tissue cells in 3 days’ culture with P.H.A.
culture. Below: blast-like
of blast-like cells after 3 days of incubation was 556±86 (a value almost identical with that obtained when autologous normal plasma was added to the same with lymphocytes from healthy children). It seems, therefore, that the plasma from our A.L.L. patients did not increase the number of blast-like cells in P.H.A.-stimulated cultures of lymphocytes from healthy children, as one would expect after the observation by Wills and Gross.1o In fact, these workers observed 10.
Wills, M., Gross, S. J. Pediat. 1965, 67,
29.
woman a
capable
of
inducing
conclusion, this work shows that peripheral-blood lymphocytes from A.L.L. and from C.L.L. behave in a definitely different way in respect of P.H.A. stimulation, perhaps because immune reactions are well preserved in acute leukaemia, whereas in C.L.L. they are impaired." In
The Blood Research Foundation Centre of Tortona is supported The Blood Research Foundation, Washington, D.C., U.S.A.
by
Department of Pediatrics G. Gaslini, University of Genoa, and Blood Research Foundation Centre, Municipal Hospital of Tortona, Italy.
G. L. R. P.
ASTALDI MASSIMO AIRÒ G. MORI.
RHEUMATOID-FACTOR-LIKE GLOBULINS AND TROPICAL PARASITIC INFECTIONS
Fig. 1-Percentages of blast-like cells obtained in tissue culture with P.H.A. from peripheral-blood lymphocytes in a group of cases of acute lymphatic leukaemia and in control groups (healthy children and chronic lymphocytic leukaemia). On the other
hand,
under the
same
experimental conditions,
the
peripheral-blood lymphocytes from healthy children in cultures with P.H.A. gave percentages of 63-3 ±6-6. The blast-like cells deriving from A.L.L. peripheral blood presented the same morphology as the blasts obtained with P.H.A. stimulation of lymphocytes from healthy persons (fig. 2). It remains to be established whether only the native small (mature) lymphocytes react to P.H.A. stimulation, or whether native immature cells (leukæmic lymphoblasts) react to it, and thus contribute to the final number of blast-like cells observed in cultures with added P.H.A. The fact that in the control cultures (without P.H.A.) the cell population after 3 days of incubation consisted chiefly of small lymphocytes (93%) may suggest that the blast-like cells are derived mostly from small lymphocytes. Secondly, in P.H.A.-stimulated cultures of lymphocytes from healthy children, to which A.L.L. plasma was added, the percentage
SIR,-Dr. Houba and Dr. Allison (April 16) write that rheumatoid-factor-like globulins seem to be a relatively common finding among Africans, although classical rheumatoid arthritis is apparently rare, and that " Africans are subject to many chronic infections, several of which might lead to formation of rheumatoid-factor-like globulins ". They found that the prevalence of rheumatoid-factor-like globulins in subjects from a malarial region in Kenya was higher than in subjects from a non-malarial region in the same country. Some years ago I12 found positive sensitised sheep-cell agglutination tests (S.S.C.A.T.) in 3 of 4 marines with Plasmodium vivax infections who had recently returned to the Netherlands from New Guinea. One or two months after discontinuance of proguanil prophylaxis they had a delayed primary attack of vivax malaria. During the active phase of this infection 3 patients showed an abnormally high S.S.C.A.T. titre (normal < 1/32), which dropped to normal some weeks after therapy had been instituted, as follows:
These observations give direct evidence that P. vivax infections can play a part in the origin of rheumatoid-factor-like
globulins. University Department of Medicine, St. Radboud Hospital, Nijmegen, Netherlands.
J. H. M. VAN TONGEREN.
DEHYDROEMETINE IN CHRONIC LEUKÆMIA SIR,-I was interested in Dr. Abd-Rabbo’s letter (May 21) describing the beneficial effect of dehydroemetine (D.H.E.) in a case of aleukæmic myeloid leukaemia in which the marrow picture returned to normal after treatment with this drug. I have also used the drug in a number of cases of malignant disease. of 75 years developed congestive heart-failure and bloody anal discharge. Sigmoidoscopy disclosed a bleeding annular carcinoma about 2 in. in breadth completely encircling the bowel about 3 in. above the anus. Biopsy on three occasions showed adenocarcinoma. She was unfit for surgical resection and she steadfastly refused to submit to radiotherapy. She was treated by two courses of 10 daily intramuscular injections of 60 mg. of D.H.E. with an interval of ten days between them. The anal bleeding ceased after the first course. At the end of a month sigmoidoscopy was repeated and no sign of the growth was present. Biopsies revealed only normal epithelium. She was followed for two years and repeated sigmoidoscopies were carried out, but no evidence of recurrence of the growth was found. She died recently of congestive heart-failure, and at necropsy no evidence of cancer was made out even in microscopic sections of the originally affected area. 11. Libansky, J. Blood, 1965, 25, 169. 12. van Tongeren, J. H. M. Ned. Tijdschr. Geneesk. 1962, 106, 1017.
A also
Fig. 2-Above: blood-picture before tissue cells in 3 days’ culture with P.H.A.
culture. Below: blast-like
of blast-like cells after 3 days of incubation was 556±86 (a value almost identical with that obtained when autologous normal plasma was added to the same with lymphocytes from healthy children). It seems, therefore, that the plasma from our A.L.L. patients did not increase the number of blast-like cells in P.H.A.-stimulated cultures of lymphocytes from healthy children, as one would expect after the observation by Wills and Gross.1o In fact, these workers observed 10.
Wills, M., Gross, S. J. Pediat. 1965, 67,
29.
woman a