Effects of cyclosporin A on refractory B-cell chronic lymphocytic leukemia.
This report details the effects of cyclosporin A (Cs-A) on the clinical course of B-cell chronic lymphocytic leukemia (B-CLL) with an increase in circulating T cells that express CD3, CD8, CD25, CD45RO, and T-cell receptor alpha beta chain. Cs-A was used for treatment of a female patient with refractory B-CLL and was shown to increase dramatically the number of leukemic B cells in association with a simultaneous increase in T cells in vivo. To study this effect more precisely, CD19+ (B cells) and CD3+ (T cells) cells were isolated from the patient and cultured in the presence or absence of Cs-A. When Cs-A was added to the culture, no cell stimulation was seen. However, CD3+ cells from the patient underwent cell death, relative to those from healthy donors. On the other hand, CD19+ cells from the patient were more resistant to Cs-A than those from healthy donors. Because in vitro experiments cannot explain this phenomenon of Cs-A increasing leukemic cells (not only B-CLL cells but also T cells), care should be exercised in the clinical use of Cs-A in B-CLL patients.
Nishii
K
K
Second Department of Internal Medicine, Mie University School of Medicine, Japan. kaz@clin.medic.mie-u.ac.jp
Katayama
N
N
Mitani
H
H
Matsumoto
T
T
Miwa
H
H
Kita
K
K
Shiku
H
H
D018941:Antigens, CD19 / Q000032:analysis; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D017252:CD3 Complex / Q000032:analysis; D002470:Cell Survival / Q000187:drug effects; D016572:Cyclosporine / Q000494:pharmacology* / Q000627:therapeutic use / Q000633:toxicity; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D007564:Japan / Q000208:ethnology; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood / Q000188:drug therapy*; D008875:Middle Aged; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology
D018941:Antigens, CD19; D017252:CD3 Complex; D016572:Cyclosporine