OKT4 epitope deficiency in patients infected with the human immunodeficiency virus: a cause of underestimation of the CD4 lymphocyte count.

Two black patients who were infected with the human immunodeficiency virus (HIV) and who had hereditary deficiency of OKT4 epitope were investigated. The patients' lymphocytes lacked the OKT4 surface antigen but reacted with other monoclonal antibodies recognizing the CD4+ helper-inducer T lymphocytes. The CD4 lymphocyte count is a surrogate marker for clinical progression of HIV disease, but it could be unreliable in regard to patients with partial or complete OKT4 epitope deficiency.

[Cancer of the kidney: changes in blood lymphocyte subsets induced by treatment with interferon alpha-2b and interleukin-2r]. / Cancer du rein: variations des populations lymphocytaires sanguines sous traitement par interféron alpha-2b et interleukine-2r.

Twenty patients (6 females and 14 males), age range 36-70 years-old, with metastatic renal cell carcinoma (MRCC), received interferon alpha-2b (IFN-A) 10 x 10(6) units/day IM for 5 days followed by continuous i.v. infusion of interleukin-2 (IL-2) 18 x 10(6) units/day for 5 days. The median follow-up was 10 months. We observed four partial responses (20%), 13 stable (65%) and three progressive diseases (15%). The mean CD4/CD8 ratio, obtained before therapy in patients with MRCC, was compared with CD4/CD8 ratio in 51 patients with different advanced malignancy and in patients with no cancer. The CD4/CD8 ratio was higher in patients with MRCC (2.55) than in other cancers (1.474) and than in populations with no cancer (1.66 x chi 2 = 17,378). The surface phenotypes of peripheral lymphocytes were analysed by cytofluorometry in patients with MRCC during and after treatment with IFN-A and IL-2. Immune modulatory effects of therapy immediately induced a decrease of different sub-populations of lymphocytes except CD25+. Far from the first course, a rise in lymphocyte count was observed. The proliferation effect was as follows: CD4+, CD8+, CD4+ CD45RA- and CD16+ CD8- cells. Far from the second and 3rd course, the sub-populations of lymphocytes decreased, except the CD4+ and CD4- CD45RA+ cells. The CD4/CD8 ratio increased progressively during treatment. Before each course, the CD4/CD8 ratio of patients with response to treatment was higher than the CD4/CD8 ratio of patients with no response. Results were non-significant due to the small number of subjects with responses in this study.

[Systemic diseases treated by corticoids, plasma exchange and cyclophosphamide: infectious complications and lymphopenia]. / Maladies systémiques traitées par corticoïdes, échanges plasmatiques et cyclophosphamide: complications infectieuses et lymphopénie.

The sporadic observation of pneumocystosis in patients suffering from systemic diseases led us to investigate the role of treatment-induced lymphopenia, affecting in particular CD4 cells. We report the results of a retrospective study on 16 patients in whom infectious complications were sought and correlated with the number of lymphocytes.

Cigarette smoking-related persistent polyclonal B lymphocytosis. A premalignant state.

A case of cigarette smoking-related polyclonal B lymphocytosis, with binucleated cells, was observed. The condition was persistent for two years. We indicated the abnormal ultrastructural features and suggest that this unexplained syndrome could be a premalignant state.