Evidence for involvement of activated CD8+/HLA-DR+ cells in the pathogenesis of neutropenia in patients with B-cell chronic lymphocytic leukaemia

Eur J Haematol. 1995 Jul;55(1):33-41. doi: 10.1111/j.1600-0609.1995.tb00230.x.

Abstract

B-cell chronic lymphocytic leukaemia (B-CLL) is often associated with peripheral blood cytopenias resulting, in most cases, from bone marrow infiltration, hypersplenism, or circulating autoantibodies. The present study was undertaken to investigate the possible involvement of a cell-mediated suppression of granulopoiesis in these patients. We studied two groups of patients, 8 neutropenic and 26 non-neutropenic, defined by the arbitrarily taken cutoff count of 2000 neutrophils/microliters. We found that neutropenic patients had higher numbers of peripheral blood CD3+, CD8+ and CD57+ cells, and higher numbers of activated CD8+/HLA-DR+ cells than the non-neutropenic ones. A negative correlation between CD8+ cells and circulating neutrophils, and a suggested negative correlation between CD8+/HLA-DR+ cells and circulating neutrophils were noted in the patients studied. Furthermore, we investigated the capacity of immunomagnetically isolated CD8+ cells to inhibit in vitro colony formation by normal granulocyte/macrophage colony-forming units (CFU-GM) and we found that inhibition was more pronounced when CD8+ cells, added in the culture, were derived from neutropenic than from non-neutropenic patients. The degree of colony inhibition correlated with the number of circulating neutrophils and the numbers of CD8+ and CD8+/HLA-DR+ cells in the patients studied. Since tumour necrosis factor-alpha (TNF-alpha) has been reported to be involved in myelosuppression, we also investigated the capacity of isolated CD8+ cells to release this cytokine into the culture supernatant fluids, and we found that comparable amounts of TNF-alpha were produced after stimulation in both neutropenic and non-neutropenic patients. Elevated serum TNF-alpha concentrations were noted only in a number of neutropenic and non-neutropenic patients. All these data taken together provide strong evidence that a T-cell subpopulation of activated CD8+/HLA-DR+ cells may be involved in the pathogenesis of neutropenia, at least in a subset of B-CLL patients, suppressing myelopoiesis by a TNF-alpha-unrelated mechanism. Efforts to isolate this cell subpopulation by flow cytometry for further analysis and a better understanding of its effect on myelopoiesis in patients with B-CLL are in progress in our laboratory.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antigen Presentation
  • CD8-Positive T-Lymphocytes / immunology*
  • CD8-Positive T-Lymphocytes / pathology
  • Cells, Cultured
  • Colony-Forming Units Assay
  • Female
  • HLA-DR Antigens / biosynthesis*
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / immunology
  • Leukemia, Lymphocytic, Chronic, B-Cell / physiopathology*
  • Lymphocyte Activation
  • Male
  • Middle Aged
  • Neutropenia / immunology
  • Neutropenia / physiopathology*
  • Tumor Necrosis Factor-alpha / analysis

Substances

  • HLA-DR Antigens
  • Tumor Necrosis Factor-alpha