title: Constitutive production of tumor necrosis factor-alpha in hairy cell leukemia: possible role in the pathogenesis of the cytopenia(s) and effect of treatment with interferon-alpha.
abstract: OBJECTIVE
  In view of the pleomorphic role cytokines play in human lymphoproliferative disorders, we investigated the possible involvement of tumor necrosis factor-alpha (TNF) in hairy cell leukemia (HCL).
  
  
  METHODS
  The levels of TNF were measured in the serum of untreated patients, and in the culture supernatants of unstimulated and stimulated enriched hairy cells (HC). Furthermore, the presence of TNF mRNA transcripts in HC was analyzed. The possibility that HC could inhibit the in vitro growth of normal erythroid progenitors via the release of TNF was also investigated. Finally, in an attempt to correlate the circulating levels of TNF with the course of the disease, these were retested during and after treatment with interferon-alpha (IFN).
  
  
  RESULTS
  Significantly increased levels of TNF were found in the sera of untreated HCL patients compared with normal control sera were seen from patients with other diseases (P less than .001), with values greater than 10 pg/mL in 21 of 42 samples tested. A significant decrease (P less than .01) of TNF levels was recorded following IFN-2a administration in 16 cases with detectable pretreatment serum levels of TNF. In two cases, an increase in TNF values was associated with persistence or progression of disease. The likelihood that the circulating levels of TNF were caused by the pathologic cells is supported by the evidence that purified HC may release TNF spontaneously. The values can be markedly increased following in vitro activation with the phorbol ester 12-0-tetradecanoylphorbol-13 acetate (PMA), with B-cell growth factor (BCGF), and, to a further extent, with the combination of PMA and BCGF. Furthermore, the constitutive mRNA for TNF was found in seven of eight HC samples analyzed. Although supernatants of enriched HC, were capable of reducing the growth of normal bone marrow erythroid progenitors by 50%, duplicate experiments using an anti-TNF antibody produced an almost complete disappearance of the inhibitory effect.
  
  
  CONCLUSIONS
  The results of this study suggest that TNF plays an important role in the pathogenesis of the cytopenia(s) characteristically associated with HCL.
authors.affiliation: Dipartimento di Scienze Biomediche e Oncologia Umana, Consiglio Nazionale delle Richerche, Torino, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Foa
authors.forename: A
authors.initials: A
authors.lastname: Guarini
authors.forename: P
authors.initials: P
authors.lastname: Francia di Celle
authors.forename: L
authors.initials: L
authors.lastname: Trentin
authors.forename: A
authors.initials: A
authors.lastname: Gillio Tos
authors.forename: G
authors.initials: G
authors.lastname: Bellone
authors.forename: A
authors.initials: A
authors.lastname: Carbone
authors.forename: C
authors.initials: C
authors.lastname: Attisano
authors.forename: M
authors.initials: M
authors.lastname: Massaia
authors.forename: D
authors.initials: D
authors.lastname: Raspadori
mesh_terms: D000328:Adult; D000368:Aged; D001772:Blood Cell Count; D003114:Colony-Forming Units Assay; D015672:Erythroid Precursor Cells / Q000166:cytology; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D016898:Interferon-alpha / Q000627:therapeutic use*; D007943:Leukemia, Hairy Cell / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000235:genetics / Q000502:physiology*
chemical_list: D016898:Interferon-alpha; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha