CD3+ T lymphocytes and interleukin 2 in myelomatous blood hyperviscosity syndrome treated with plasmapheresis.

The study was aimed at testing changes of absolute CD3+ T lymphocyte counts and serum interleukin 2 (IL-2) concentrations in 20 patients suffering from myelomatous and macroglobulinemic hyperviscosity syndrome. Mean values have been calculated from assays made before treatment, immediately after plasmapheresis (PP) and after 1 month of subsequent chemotherapy. Patients showing hyperviscosity displayed initial IL-2 values ranging from 529 to 2722 pg/ml. These levels were significantly (p = 0.001) higher than in healthy subjects, in whom IL-2 was undetectable. Absolute CD3+ counts in patients with hyperviscosity ranged from 600 to 1290 G/l and were significantly (p = 0.05) lower than in healthy controls with a range of 1110-1520 G/l. In 6 patients in coma or precoma serum IL-2 concentrations were insignificantly and absolute CD3+ counts significantly (p = 0.02) lower than in hyperviscosity patients with less severe symptoms. After PP the previously elevated serum IL-2 levels diminished by 20%, but absolute CD3+ counts remained unchanged. After 1 month of chemotherapy IL-2 levels increased again in 15 multiple myeloma (MM) patients, but in all patients with Waldenstrom's macroglobulinemia (WM) a further decrease of serum IL-2 level was observed. By that time CD3+ counts increased significantly (p = 0.01) being higher than initial values. Effects of combined myeloma treatment and prognostic value of serum IL-2 level and absolute number of CD3+ determination are discussed.