Theophylline, a new inducer of apoptosis in B-CLL: role of cyclic nucleotides.

We report a case of indolent B-chronic lymphocytic leukaemia (B-CLL) in a stage A patient, treated for 10 years only by theophylline for bronchial asthma. As suggested by the spontaneous apoptosis in the patient's blood (10%), theophylline at 50 micrograms/ml increased spontaneous apoptosis after 72 h in culture by a mean percentage of 90% (range 79-98%) in six B-CLL cases studied in vitro. This effect was partially reversed with Rp-cAMP, a cAMP antagonist, which implies a potent role for this second messenger. We describe a new property of theophylline, which might be an alternative treatment in B-CLL.