Leukocyte function in patients with leukemia

Abstract

The phagocytic ability of neutrophilic leukocytes from patients with leukemia was studied using live Candida albicans as the test organism. In 19 patients with acute myeloblastic leukemia (AML), the mean yeast cell number per neutrophil (phagocytic index) and the percent neutrophils which ingest Candida (percent phagocytosis) were normal. However, death of leukocytes was significantly increased. Candidal germ tube formation (both in number and size) and leukocyte clumping were markedly diminished. Similar findings were observed in 2 patients with acute lymphoblastic leukemia (ALL) in relapse. All these parameters were normal in 2 other patients with ALL in remission. In 6 patients with chronic myelocytic leukemia (CML), the phagocytic index was significantly reduced, but the percent phagocytosis and death of neutrophils were normal. Germ tube formation and leukocyte clumping were also diminished. During remission, the phagocytic index returned to normal. It is suggested that neutrophils from patients with AML in relapse are able to ingest live yeast organisms but are not capable of normally killing them. Neutrophils of patients with CML also have impaired ability to ingest Candida. A biochemical or lysosomal defect of the neutrophil is postulated.