Reporte de la Primera Reunión Nacional de Consenso para la Inmunofenotipificación de Leucemias Agudas / Report of the First National Consensus Meeting for the Immunophenotyping of Acute Leukemias

Resumen En 2005 se publicaron recomendaciones para la tipificación de hemopatías malignas en Latinoamérica. Se consideró necesario realizar una reunión nacional para actualizarlas. Se convocaron y reunieron 95 profesionales expertos en el tema para analizar y contrastar alternativas y llegar a un consenso. Se alcanzaron opiniones de consenso en lo relativo a indicaciones, tipos y manejo de muestras, anticuerpos, nomenclatura e informe de resultados para el diagnóstico y seguimiento de las leucemias agudas. Las recomendaciones se describen en este artículo y se hace hincapié en la necesidad de que los laboratorios nacionales se apeguen a ellas.

Abstract Recommendations for the typing of hematological malignancies in Latin America were published in 2005. Carrying out a national meeting to update them was deemed necessary. 95 professional experts on the subject were invited in order to analyze and contrast alternatives and reach a consensus. Consensus opinions were reached regarding indications, sample types and processing, antibodies, nomenclature and reporting of results for the diagnosis and monitoring of acute leukemias. This paper describes the recommendations and emphasizes on the need for national laboratories to adhere to them.

The need for endodontic treatment and systemic characteristics of hematopoietic stem cell transplantation patients

Abstract The aim of this study is to investigate the relationship between the epidemiological and clinical profiles of patients before and after hematopoietic stem cell transplantation (HSCT) and the need for endodontic treatment. The subjects included 188 individuals enrolled in the dental care program for transplanted patients of the School of Dentistry, Federal University of Minas Gerais (Faculdade de Odontologia da Universidade Federal de Minas Gerais, FO-UFMG) from March 2011 through March 2016. The patients were subjected to an HSCT conditioning dental regimen based on a thorough clinical and radiographic evaluation. Intraoral periapical and bite-wing X-rays were obtained, and after evaluation, specific dental treatment was planned and performed. The following demographic and clinical data were collected from the patients' medical records: age, gender, transplantation stage, primary disease, transplant type, medication used, complete blood count at the time of visit, and need for endodontic treatment. The Kolmogorov-Smirnov and the chi-square tests were used. Leukemia (31.3%) and multiple myeloma (17.9%) were the most prevalent primary diseases. Most patients were subjected to allogeneic-related transplantation (83.6%). Most patients exhibited platelet counts and hemoglobin concentrations below the reference values in the pre-transplantation stage, while the neutrophil and platelet counts and the hemoglobin levels were within the reference ranges in the post-transplantation stage. The proportions of individuals requiring endodontic treatment were similar between the pre- and post-transplantation groups: 24.3% and 24.7%, respectively. The systemic conditions of the patients referred for dental treatment were compromised.

Complexos triazenidos de platina (II): Avaliação in vitro da atividade antibacteriana e citotóxica frente a bactérias e células de medula óssea de pacientes leucêmicos de um hospital escola / Triazenidos complexes of platinum (II): In vitro evaluation of antibacterial and cytotoxic activity against bacteria and bone marrow cells from leukemic patients in a university hospital

Atualmente, apesar da ampla gama de substâncias ativas existentes, progressivamente tem se limitado o arsenal terapêutico disponível na prática clínica, isto se deve, especialmente, pelo surgimento da resistência aos agentes terapêuticos utilizados no tratamento de tumores e infecções bacterianas. Em virtude das diversas propriedades farmacológicas demonstradas pelos triazenos (TZCs), avaliaram-se compostos inéditos na busca de novos agentes biologicamente ativos, estes foram denominados C1 e C2. A atividade antibacteriana foi realizada pelo método convencional da microdiluição em caldo, através da técnica da Concentração Inibitória Mínima (CIM), frente a cepas bacterianas de referência American Type Culture Collection (ATCC) e isolados clínicos com resistência múltipla as drogas (RMD). A citotoxicidade foi analisada através do ensaio colorimétrico baseado na redução do brometo de 3-(4,5-dimetiltiazol-2-il)-2,5?difeniltetrazólio frente a células da medula óssea de dois pacientes (P1 e P2) atendidos no Hospital Universitário de Santa Maria. Os dois compostos testados apresentaram atividade antibacteriana em 26,08% (6/23) das cepas testadas, sendo ativos em 38,46% (5/13) das cepas ATCC e 10% (1/10) dos isolados clínicos RMD, apenas em espécies caracterizadas como Gram positivas. Os resultados foram satisfatórios para ambos os compostos frente à amostra P2, células mononucleares de Leucemia Mielóide Crônica, pois demonstraram indução da morte celular. Pode-se concluir que os resultados obtidos desses compostos demonstraram a existência de atividade antibacteriana, bem como, atividade antileucêmica promissora. Pesquisas complementares relacionadas a esses compostos estão em andamento.(AU)

Currently, despite the wide range of existing active substances has been progressively limited therapeutic arsenal available in clinical practice, this is, in particular, the emergence of resistance to therapeutic agents used in treating tumors and bacterial infections. Because of the diverse pharmacological properties demonstrated by triazenes (TZCs) - evaluated whether unpublished compounds in the search for new biologically active agents, they were called C1 and C2. The antibacterial activity was performed by the conventional method of broth microdilution, using the technique of Minimum Inhibitory Concentration (MIC) against the bacterial strains reference American Type Culture Collection (ATCC) and clinical isolates with multiple drug resistance (MDR). Cytotoxicity was analyzed by colorimetric assay based on the reduction of the bromide of 3 - (4,5- dimethylthiazol-2- yl) -2,5- diphenyltetrazolium against bone marrow cells from two patients (P1 and P2) seen at the Hospital university of Santa Maria. The two compounds tested showed antibacterial activity in 26.08% (6/23) of the strains, being active in 38.46 % (5/13) of the ATCC strains and 10 % (1/10) of clinical isolates MDR only characterized in species such as Gram positive. The results were satisfactory for both the sample compounds front P2, mononuclear cells from chronic myeloid leukemia, as demonstrated induction of cell death. It can be concluded that the results demonstrated the existence of these compounds to antibacterial activity, as well as promising antileukemic activity. Additional research related to these compounds are in progress.(AU)

Inmunofenotipos aberrantes en leucemias agudas en una población hospitalaria de Buenos Aires / Aberrant immunophenotypes in acute leukemia in a Buenos Aires' hospital population

La citometría de flujo multiparamétrica es el método de elección para la caracterización inmunofenotípica de las células hematopoyéticas clonales presentes en los distintos procesos leucémicos agudos. El objetivo fue analizar la expresión de antígenos de membrana y evaluar la presencia de fenotipos aberrantes en los blastos de pacientes con diagnóstico de leucemia aguda, que permiten el monitoreo de la respuesta al tratamiento. Se revisaron los inmunofenotipos de 364 muestras de pacientes adultos derivadas a nuestro laboratorio en un período de 7 años. El inmunofenotipo se realizó por citometría de flujo con un amplio panel de anticuerpos monoclonales con el que se evaluó la expresión de antígenos de linaje linfoide, mieloide y también antígenos de maduración. De las 364 muestras estudiadas, 60.2% presentaron un fenotipo compatible con leucemia mieloide aguda (LMA), 28.8% con leucemia linfoblástica B (LLA-B), 6.6% con leucemia linfoblástica T (LLA-T) y 4.4% con leucemias agudas poco frecuentes. La presencia de fenotipos aberrantes se observó en 89% de los casos, los fenotipos aberrantes identificados fueron: 1) infidelidad de linaje: LMA (54%), LLA-B (40%), LLA-T (29%); 2) ausencia de expresión antigénica: LMA (21%), LLA-B (35%), LLA-T (70%); 3) alteración de la expresión antigénica: LMA (67%), LLA-B (66%), LLA-T (84%); 4) asincronismo madurativo: LMA (26%), LLA-B (37%) y 5) fenotipo ectópico: LLA-T 96%). El análisis por citometría de flujo multiparamétrica de las leucemias agudas permitió la identificación de fenotipos aberrantes en la mayoría de nuestros pacientes, que son de utilidad para el monitoreo de la respuesta al tratamiento.

Multiparameter flow cytometry (MFC) has become the preferred method for the lineage assignment and maturational analysis of malignant cells in acute leukemias. Multiparametric immunophenotyping analysis allows the detection of aberrant antigen expression and the analysis of heterogeneity and clonality of malignant cells in leukemias. Our objectives were to analyze the membrane antigen expression and to evaluate if the aberrant phenotypes occurrence in blasts cells of patients with acute leukemia is useful in monitoring the response to the treatment. We have retrospectively analyzed the MFC data of 364 samples sent to our laboratory in a 7 years period. For this purpose we have used a large panel of monoclonal antibodies against lymphoid, myeloid and precursors antigens. From the 364 analyzed samples, 60.2% showe d a phenotype compatible with acute myeloid leukemia (AML), 28.8% with B lymphoblastic leukemia (B-LLA), 6.6% with T lymphoblastic leukemia (T-LLA) and 4.4% with rare leukemias. Aberrant phenotypes were found in 86% of the samples. The aberrant phenotypes identified were:1) lineage infidelity AML (54%), B-ALL (40%), T-ALL (29%); 2) absence of antigen expression: AML (21%), B-ALL (35%), T-ALL (70%); 3) altered antigen expression: AML (67%), B-ALL (66%),T-ALL (84%); 4) asynchronous expression: AML (26%), B-ALL (37%) and 5) ectopic phenotype: T-ALL (96%). Multiparameter flow cytometry of acute leukemias allowed identification of aberrant phenotypes in the majority of our patients, that are helpful for monitoring treatment response.

IL-1 alpha and il-8levels during gram-negative and gram-positive bacteremia in leukopenia leukemic patients

A quantitative relationships between circulating leukocytes and infection was established in patients with leukemia, in particular, the probability of being infected is proportional to the severity and duration of leukopenia [1]. Infection with gram- negative as well as gram-positive microorganisms may lead to septic shock and death [2, 3]. The major functional activities of cytokines are concerned with the regulation of the development and behavior of the immune effector cells. IL-1 is one of proximal cytokines. IL-1 act to stimulate the release of distal cytokines, such as IL-6 and IL-8, IL-8 is most closely related to the severity of the physiological response to infection and systemic inflammation. This study was conducted to detect the levels of IL-1 and IL-8 during Gram negative and Gram positive bacteremia. That could be useful in determining an appropriate choice for antimicrobial drug depending on the antimicrobial susceptibility pattern. IL-1 alpha and IL-8 was studied in [28] adult leukopenic patient with bacteremia, males and females, more than 15 years old. The study was including [20] healthy control. The bacteremic cases were obtained by culturing blood samples aerobically and anaerobically. The isolates were identified on the basis of their morphological, cultural and biochemical characteristics. Interleukin-1 alpha and interleukin-8 cocentration were measured by using a commercially available enzyme-linked immunosorbent assay [ELISA]. Statistical analysis show no significant difference in IL-1 alpha levels between Gram-negative and Grampositive bacteremia in leukopenic leukemia patients [P=0.803]. While statistical analysis show significant difference between patient with Gram-negative and Gram-positive bacteremia in leukopenic leukemia patients [P=0.037]. In leukopenic leukemia patients with bacteremia we may could determining an appropriate choice for treatment depending on IL-8 levels in the circulation of those patients and the antimicrobial susceptibility pattern

Derivation of leukemic plasmacytoid dendritic cells coexpressing a progenitor cell surface antigen, CD117, without interferon-alpha production.

CD4+CD56+ lineage negative malignancy has recently been considered as plasmacytoid dendritic cell (PDC) leukemia/lymphoma. We investigated immunophenotypic and functional characterizations of PDC leukemic cells in one case. Lineage markers were all negative except partially positive CD11c and positive CD117, indicating malignant cells were leukemic PDCs coexpressing myeloid and progenitor cell surface antigens. Leukemic PDCs cultured with IL-3 increased in size and expression of CD11c, CD40 and HLA-DR, although the cells cultured with IL-2 or GM-CSF showed little proliferation. Furthermore, CD40 ligation after IL-3 stimulation yielded morphological changes such as expression of dendritic process. These findings showed that malignant cells were consistent with leukemic PDCs. However, secretion of interferon-alpha was not detected in leukemic PDCs with the stimulation of CpG ODN or inactivated herpes simplex virus-1.

Leucemia de células natural killer: Caso clínico / Natural killer cell leukemia: Case report

Natural killer leukemia is a rare and highly aggressive neoplasm, is more common in young male patients and has a very poor prognosis, with a median survival of few weeks. We report a 17 years old male patient who developed, after an acute upper respiratory disease, a rapidly multiorganic failure with pancytopenia. Bone marrow aspiration and trephine biopsy showed an acute lymphoblastic leukemia. The immunophenotype and immunohistochemistry revealed a natural killer acute leukemia. The disease progressed rapidly and the patient died shortly after the diagnosis.

Frequência dos polimorfismos dos genes do TNF alfa e da MTHFR em um grupo de pacientes leucêmicos da cidade do Salvador-Ba / Frequency of gene polymorphisms of TNF alpha and MTHFR in a group of leukemia patients in Salvador-Ba

As leucemias são neoplasias hematológicas decorrentes do desequilíbrio entre as taxas de proliferação, maturação e apoptose das células hematopoéticas, comumente associadas com polimorfismos gênicos. Polimorfismos nos genes do TNFa e da enzima MTHFR têm sido associados como fatores de susceptibilidade para diversas patologias, inclusive neoplasias hematológicas. O presente estudo investigou a freqüência do polimorfismo -308 da região promotora no gene do TNFa, cuja variante genotipica AA está associada a níveis de transcrição elevados da citocina, e dos polimorfismos C677T e A1298C no gene da MTHFR, que estão associados com atividade enzimática reduzida. Para investigação dos polimorfismos foi utilizada a técnica de PCR-RFLP. Foram estudados 94 pacientes leucêmicos, sendo 66 portadores de LMC e 28 de LMA-M3, além de 100 indivíduos da população de Salvador. Dos 66 pacientes com LMC, cinco (7,6%) foram homozigotos para a variante genotipica menos comum (AA) do polimorfismo -308 do TNF. Essa freqüência foi de 3,7% entre os 28 portadores de LMA-M3 e de 3,0% entre os indivíduos do grupo populacional. Dentre os portadores de 66 LMC, dois (3,0%) foram homozigotos para a variante TT do polimorfismo C677T da MTHFR, sendo que foi encontrada frequência de 7,1% entre os portadores de LMA- M3 e de 6,0% para o grupo populacional. Para o polimorfismo A1298C da MTHFR, as freqüências encontradas para a variante CC foram de 4,5% entre os 66 portadores de LMC, 3,6% entre os 28 portadores de LMA-M3 e 5,0% entre os indivíduos do grupo populacional. Diante dos resultados obtidos, concluímos que os polimorfismos -308 (TNFa), bem como C677T e A1298 (MTHFR) parecem não interferir diretamente com os mecanismos de patogênese da LMC e LMA-M3.

Freqüência de imunofenótipos aberrantes em leucemias agudas / The frequency of aberrant immunophenotypes in acute leukemias

As leucemias agudas (LA) são doenças heterogêneas, com características clínicas, morfológicas, imunológicas emoleculares distintas. Por meio destas particularidades, as leucemias são classificadas em seus diversos subtiposbiológicos. Neste estudo, nós analisamos a freqüência de fenótipos aberrantes (FA) em pacientes com leucemias,provenientes de diferentes regiões do Brasil, com o objetivo de avaliar estes FAs nos estudos futuros sobre doençaresidual mínima. Análises por citometria de fluxo multiparamétrica permitem o conhecimento da diferenciaçãohematopoética normal, bem como o perfil da diferenciação nas leucemias. O painel original com anticorposmonoclonais (AcMo) consistiu de marcadores distribuídos em associações ou testes com simples marcações.Entre os casos leucêmicos analisados neste estudo, 8,33 por cento correspondem a amostras cujos blastos expressam FA.A leucemia linfoblástica aguda (LLA) foi responsável por 46,67 por cento dos casos com anomalia de fenótipo, enquantoa leucemia mielóide aguda (LMA) atendeu por 53,33 por cento dos casos com FA. Entre os casos de LLA, o fenótipo maisfreqüente foi CD10+/CD13+. Em relação a LMA, a expressão do CD7 foi predominante, principalmente entre ossubtipos M0, M1 e M2, seguida do CD56+ e do CD19+. As análises nos indicaram pequenas diferenças nasfreqüências de FAs nos diferentes estados brasileiros. No entanto, estas diferenças devem ser valorizadas naaplicação de painel de AcMo, nas pesquisas de doença residual mínima em nossa população.

Leukemia in infants.

OBJECTIVE: Acute Leukemia is rare in infants. It is characterized by non-specific symptomatology requiring a high index of suspicion on the part of a pediatrician for referral and diagnosis. It has peculiar biological features, unresponsiveness to treatment and poor prognosis. METHODS: Eighteen infants with acute leukemia were seen during 1994 to 2001 and were analyzed on the basis of clinical and laboratory data. There were 13 cases of Acute Lymphoblastic Leukemia (ALL), 4 cases of Acute Myeloid Leukemia (AML) and one case remained unclassifiable, as the surface markers could not be done. Morphologically 9/13 cases of ALL were of FAB L1 type and remaining of L2 subtype, and 2/4 cases of AML were of FAB M1 type and remaining of M2 subtype. RESULT: Clinical data was available completely only in 11 cases. Hyperleucocytosis was present in 4 cases, organomegaly in 8 cases and lympadenopathy in 5 cases. One patient presented with a chloroma in the retrorbital region although there was no parenchymal involvement of the brain. Immunophenotyping could be done in 13 cases, where 7 cases were diagnosed as CALLA positive-ALL (HLADR+, CD19+, CD10+), 2 cases as Early Pre-B ALL (HLADR+, CD19+, CD10 negative), one as T ALL (cCD3+, CD2+, CD7+) and 3 cases as AML (CD13+, CD33+, HLADR+). None of our patients received treatment.

Assessment of residual disease in acute leukemia by means of polymerase chain reaction / Evaluación de enfermedad residual en leucemia aguda por medio de reacción en cadena de la polimerasa

Empleando reacción en cadena de la polimerasa (PCR) se buscaron marcadores moleculares específicos en 75 pacientes consecutivos con leucemia aguda en una sola institución a lo largo de un periodo de cinco años. En leucemia aguda linfoblástica se buscaron BCR/ABL t (9:22), TEL-AML1, t (12:21) y rearreglos clonotípicos de los genes de inmunoglobulinas, en tanto que en leucemia aguda mieloblástica se buscaron PML-RARa t (15:17), AML1-ETO t (8:21) y CBFb-MYH11 (inv16). Se identificaron marcadores moleculares en 15 de 75 casos: cuatro LAL (tres rearreglos de Ig y uno BCR/ABL) y 11 LAM (9 PML/RARa y 2 AML1/ETO). A lo largo de seguimientos de 1 a 60 meses después de haber hecho el diagnóstico, en siete pacientes se eliminó la enfermedad residual evaluada por PCR (ER-PCR) y en ocho persistió. Para pacientes sin o con ER-PCR, la supervivencia (SV) a 30 meses fue de 86 por ciento y 14 por ciento, y la mediana de SV >60 y dos meses, respectivamente (p < 0.01). Seis de los ocho pacientes con ER-PCR fallecieron y en dos se pudo lograr una nueva remisión molecular. Dos de las tres recaídas moleculares pudieron detectarse antes de la recaída hematológica florida. Se concluye que la PCR es útil para vigilar la persistencia de ER en leucemia aguda y en ocasiones, para decidir los tratamientos antileucémicos de rescate, de manera oportuna.

Combined method for simultaneous morphology, immunophenotype and karyotype (MAC) in leukemias

In the present study, a combined method (CM) for attaining simultaneous identification of leukemic cell morphology, karyotype and immunophenotype has been evaluated in 21 patients with acute leukemia and 1 with CML in blast crisis were studied for morphology citochemistry, immunophenotype and karyotype. Karyotype was performed in a bone marrow sample by using conventional techniques. In each case, direct method (DM) and/or three cultures were tried. The CM consisted in separating a small part of the material resulting from any of the cultures or DM, preparing slides through cytospin and immunophenotyping through APAAP method using the same monoclonal antibodies (MoAb) as for diagnosis. In 14 cases, the metaphases proved positive to the MoAb: in 4, the cells with abnormality had their origin defined; in other 4 the karyotype was normal preventing any identification; 6 cases had minimal abnormalities not visible through CM; and in two cases abnormal karyotypes were detected only in the cultures with GM-CSF. This study showed that CM is feasible in cases where evident numerical or structural chromosomal abnormalties are present.

Concurrencia de marcacion citoquimica e inmune de diferentes linajes celulares en casos de leucemias agudas / Concurrence of cytochemical and immune patterns of different cellular lineages in cases of acute leukemia

Se registra la sinonimia entre leucemia mixta, bilineal, biclonal e híbrida, diferenciándola de leucemia bifenotípica. Se define leucemia aguda mixta (LA mixta) como aquella en la que coexistem 1) dos caracteres citoquímicos de línea diferente, o 2) uno de ellos y más de uno inmunológico opuesto, o 3) más de uno inmunológico opuesto a otra línea inmune. Se aportan 7 casos (5 de LA mixta común y 2 de viraje postratamiento). Se concluye que el carácter mixto de una leucemia aguda empeora el pronóstico y se discute la selección de la terapêutica.

Caracterizacion inmunobiologica de la leucemia murina LB y la linea celular LBC / Immunobiological characterization of the murine LB leukemia and the LBC cell line

El tumor LB se originó como una leucemia linfoide de origen espontáneo. No es inmunogénico y crece rápidamente en el huésped singeneico infiltrando hígado, bazo y ganglíos linfáticos. A partir del tumor original se obtuvo la línea en cultivo LBC, que crece en suspensión, no requiere del agregado de factores de crecimiento y presenta un número modal de cromosomas igual al patrón normal de ratón. La caracterización fenotípica de las células LB y de la línea en cultivo demostró que ambos tipos celulares están constituídos por linfocitos T, CD3-, CD25+, gp 70-, J22d.2+, que expresan antígenos del CMH de clase I pero no de clase II, CD8+, y CD4- en el tumor original pero CD4+ en la línea celular. Esta última fue capaz de inducir una respuesta inmune en el huésped singeneico, mediada por anticuerpos que reaccionaron contra componentesde peso molecular 14, 16 y 27 kDa presentes en las células tumorales y en timocitos pero no en ganglios normales, y por células citotóxicas, efectivas para retardar el tiempo de muerte de los ratones desafiados con el tumor original LB. Por ELISA se pudo comprobar la presencia de receptor soluble de IL-2 en los sueros, ascitis y sobrenadantes de células LB en cultivo, responsable del efecto inhibitorio de la proliferación tumoral. Las células fueron estimuladas por agregado de IL-2 e inhibidas en presencia de un anticuerpo monoclonal específico para IL-2, demostrando la funcionalidad del receptor. Por RT-PCR se puso en evidencia la presencia de ARNn de IL-2 en las células tumorales, confirmando que éstas sintetizan IL-2. Se realizó una triple transfección de las células LBC con los genes que codificam para las cadenas alpha y beta de las moléculas I-A(d) y el gen pSV2-Neo, que confiere resistência al antibiótico Genetecín, y se obtuvieron 3 clones positivos para I-A(d). Por inoculación de estas células se generaron linfocitos T citotóxicos que fueron efectivos para impedir o retrasar significativamente el desarrollo tumoral. En función de estos resultados postulamos que la expresión de antígenos de clase II sobre la superfície celular le confiere a la célula tumoral la capacidad para actuar como célula presentadora de antígenos, generando una respuesta anti-tumoral más eficiente.

Peripheral blood lymphocyte subsets after allogeneic bone marrow transplantation: reconstitution and correlation with the occurrence of acute graft-versus-host disease.

Peripheral blood lymphocyte subsets were enumerated at regular intervals during the first year after allogeneic bone marrow transplantation (BMT) in 21 Chinese patients. Eight of these patients had acute graft-versus-host disease (GVHD) while they were assessed at the time of engraftment. Our results show in patients receiving allogeneic BMT: (1) T and NK cells were the predominant lymphocyte subsets in the early reconstitution stage while B cells were severely depleted; (2) absolute numbers of the major lymphocyte subsets normalised in 4-5 months; (3) an increased percentage of T cells that expressed the activation antigen HLA-DR and a reversed CD4:CD8 ratio were observed throughout the first 12 months after BMT; (4) patients with acute GVHD had significantly higher white cell count and NK cell percentage than those not complicated by acute GVHD.

Effect of gamma interferon on the expression of class I MHC antigens on fresh leukemic cells and their susceptibility to lysis by lymphokine activated killer cells.

Relationship between MHC class I antigen expression on PBLs from leukemia patients and their susceptibility to lysis by LAK cells was investigated. LAK cells induced small yet significant lysis of leukemic cells. In nine out of 14 cases studied, treatment with Interferon gamma (200 U/ml for 48 hours) resulted in a decrease in the LAK susceptibility of leukemic cells. In six of these cases, there was a concomitant increase in the expression of class I MHC antigen expression. In three samples, the increase in MHC class I antigen expression was not accompanied by a decrease in LAK susceptibility. IFN treatment had no effect on the binding of leukemic cells to LAK effector cells.

Citometria de fluxo em imunofenotipagem celular: I. perfil imunológico de linfócitos circulantes / Flow cytometry in cell immunophenotyping: I. immunologic profile of the circulating lymphocytes

O aprimoramento de técnicas biológicas obtidas nestes últimos anos, cresceu com o desenvolvimento da citometria de fluxo, fruto da colaboraçäo entre engenheiros e biologistas. No seu desenvolvimento, a citometria de fluxo tornou-se uma aliada muito próxima de outra biotecnologia que é a produçäo de anticorpos monoclonais, que por sua vez se desenvolveu mais ainda com a diversificaçäo da química fluorescente e com as conjugaçöes e combinaçöes de diversos reagentes enzimáticos. Nesta revisäo nós nos propormos rever a aplicabilidade da citometria de fluxo nas análises de fenótipo de células linfóides periféricas, as funçöes celulares e estudos de subpopulaçöes em indivíduos portadores da síndrome de imunodeficiência ou AIDS.

Prevalencia de seropositividad a citomegalovirus en pacientes con neoplasias hematológicas / Seroprevalence infection with sytomegalovirus in hematological malignancies patients

La infección por citomegalovirus es ubicua y generalmente asintomática. La reactivación o infección primaria en pacientes con cáncer, particularmente leucemia y linfoma, en individuos con inmunosupresión celular y receptores de transplante, establecen a este virus como importante patógeno en humanos. Con el propósito de determinar la prevalencia de seropositividad a cintomegalovirus en pacientes con neoplasias hematológicas en el Instituto Nacional de Cancerología, se realizó la detección de anticuerpos séricos totales contra citomegalovirus en un grupo de pacientes con este padecimiento. La prevalencia de seropositividad a citomegalovirus fue eleva uniformemente mayor de 85 por ciento en los cuatro grupos de estudio, independiente de sexo y diagnóstico. De los factores estudiados, la edad fue el único que se asoció a la presencia de anticuerpos contra citomegalovirus. Es necesario extender estos resultados, a través de un análisis comparativo en muestras de individuos de otras instituciones con diferentes niveles de ingreso. De esta manera, se podrá obtener mejor conocimiento de la distribución de infección de este virus en la población mexicana.