Studies on the immune status of children with acute lymphocytic leukaemia. I. Early phase before and after first remission.

Seventeen children of 2-15 years of age with newly diagnosed untreated acute lymphatic leukaemia (ALL) were evaluated with a number of immunological tests: for humoral immunity serum immunoglobulins and reactive antibody formation against three antigens (diphtheria, tetanus, KLH); for cell-mediated immunity in vitro response of blood lymphocytes against PHA; membrane characteristics of blood lymphocytes and lymphoid blasts for both B and T cells. The tests were repeated in thirteen patients who attained full remission. In the majority (twelve cases) no surface markers were detected (null-cell leukaemia), one patient fulfilled the criteria for a T-cell leukaemia with thymoma. Four patients had rather high absolute B-cell counts, but did not fulfill all the criteria for B-cell leukaemia; three of them died before remission. Immune globulin concentrations were only slightly changed, antibody formation, both primary and anamnestic, was possible. PHA response was extremely low in the initial phase, but normal immediately after remission. During remission all patients were markedly depleted in both their B- and T-cell compartment.