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Abnormal T-Cell Subsets and Mitogen Responses in Hemophiliacs Exposed to Factor Concentrate FREE

Jane C. Unzeitig, MD; Joseph A. Church, MD; Edward D. Gomperts, MD; Carol A. Nye; Stephen Pasquale, PhD; Warren Richards, MD
[+] Author Affiliations

Reprint requests to Allergy—Clinical Immunology Division, Childrens Hospital of Los Angeles, PO Box 54700, Terminal Annex, Los Angeles, CA 90054 (Dr Church).


Am J Dis Child. 1984;138(7):645-648. doi:10.1001/archpedi.1984.02140450027008.
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• The acquired immune deficiency syndrome (AIDS) has been reported in hemophiliacs. We examined lymphocyte numbers and functions in 28 patients with hemophilia and 16 healthy adults. Healthy hemophiliacs who had received fewer than 150 commercial factor concentrate (CFC) infusions had normal T-cell numbers, T-cell subsets, and mitogen responses. Healthy hemophiliacs who had received more than 250 CFC infusions had a decreased number of Leu 3+ "helper" T cells, a decreased Leu 3–Leu 2 ratio, and decreased pokeweed mitogen responses. Hemophiliacs who had received greater than 250 CFC infusions and who had persistent lymphadenopathy had decreased Leu 3+ cells, increased Leu 2+ "suppressor" T cells, a decreased Leu 3–Leu 2 ratio, and decreased phytohemagglutinin responses. Abnormal results of T-cell studies were found in 67% of healthy hemophiliacs who had a high degree of CFC exposure and 100% of clinically abnormal hemophiliacs. These findings suggest that hemophiliacs are at risk for the development of the immunologic changes that characterize AIDS and that this risk is related to CFC exposure.

(AJDC 1984;138:645-648)

REFERENCES

Gottlieb MS, Schroff R, Schanker HM, et al:  Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: Evidence of a new acquired cellular immunodeficiency . N Engl J Med 1981;;305:1425-1431.
Masur H, Michelis MA, Green JB, et al:  An outbreak of community-acquired Pneumocystis carinii pneumonia . N Engl J Med 1981;;305: 1431-1438.
Small CB, Kelin RS, Friedland GH, et al:  Community-acquired opportunistic infections and defective cellular immunity in heterosexual drug abusers and homosexual men . Am J Med 1983;;74:433-441.
Pitchenik AE, Fischl MA, Dickinson GM, et al:  Opportunistic infections and Kaposi's sarcoma among Haitians: Evidence of a new acquired immunodeficiency state . Ann Intern Med 1983;; 98:277-284.
 Pneumocystis carinii pneumonia among persons with hemophilia A . MMWR 1982;;31: 365-367.
Spero JA, Lewi JH, Van Thiel DH, et al:  Asymptomatic structural liver disease in hemophilia . N Engl J Med 1978;;298:1373-1378.
Gomperts ED, Lazerson J, Berg D, et al:  Hepatocellular enzyme patterns and hepatitis B virus exposure in multitransfused young and very young hemophilia patients . Am J Hematol 1981;;11:55-59.
Boyum A:  Ficoll-Hypaque method for separating mononuclear cells and granulocytes from human blood . Scand J Clin Lab Invest 1968;;21 ( (suppl 97) ):77.
Oppenheim JJ, Schecter B:  Lymphocyte transformation , in Rose NR, Friedman H (eds): Manual of Clinical Immunology . Washington, DC, American Society for Microbiology, 1976;, pp 81-94.
Schroff RW, Food KA, Billing RJ, et al:  Immunologic classification of lymphocytic leukemias based on monoclonal antibody-defined cell surface antigens . Blood 1982;;59:207-215.
 Update on acquired immune deficiency syndrome (AIDS) among patients with hemophilia . MMWR 1982;;31:644-652.
Ragni MV, Spero JA, Lewis JH, et al:  Acquired immunodeficiencylike syndrome in two hemophiliacs . Lancet 1983;;1:213-214.
Davis KC, Horsburgh CR, Hasiba U, et al:  Acquired immunodeficiency syndrome in a patient with hemophilia . Ann Intern Med 1983;;98: 284-286.
Poon M-C, Landay A, Prasthofer EF, et al:  Acquired immunodeficiency syndrome with Pneumocystis carinii pneumonia and Mycobacterium avium—intracellular infection in a previously healthy patient with classic hemophilia . Ann Intern Med 1983;;98:287-290.
Elliott JL, Hoppes WL, Platt MS, et al:  The acquired immunodeficiency syndrome and Mycobacterium avium—intracellular bacteremia in a patient with hemophilia . Ann Intern Med 1983;;98:290-293.
Weintraub P, Ammann AJ, Abrams DI, et al:  Altered T-cell immunity in hemophiliacs receiving frequent factor VIII concentrate . Blood 1982;;60:244a.
Lederman MM, Ratnoff OD, Scillian JJ, et al:  Impaired cell-mediated immunity in patients with classic hemophilia . N Engl J Med 1983;;308:79-83.
Menitove E, Aster RH, Casper JT, et al:  T-lymphocyte subpopulations in patients with classic hemophilia treated with cryoprecipitate and lyophilized concentrates . N Engl J Med 1983;; 308:83-86.
Jones P, Proctor S, Dickinson A, et al:  Altered immunology in hemophilia . Lancet 1983;; 1:120-121.
Goldsmith JC, Moseley PL, Monick M, et al:  T-lymphocyte subpopulation abnormalities in apparently healthy patients with hemophilia . Ann Intern Med 1983;;98:294-296.
Saidi P, Kim HC, Raska K:  T-cell subsets in hemophilia . N Engl J Med 1983;;308:1291-1292.
Landay A, Poon M-C, Abo T, et al:  Immunologic studies in asymptomatic hemophilia patients . J Clin Invest 1983;;71:1500-1504.
Luban NLC, Kelleher JI, Reaman GH:  Altered distribution of T-lymphocyte subpopulations in children and adolescents with hemophilia . Lancet 1983;;1:503-505.
Stahl RE, Friedman-Kien A, Dubin R, et al:  Immunologic abnormalities in homosexual men: Relationship to Kaposi's sarcoma . Am J Med 1982;;73:171-178.
Kornfeld H, Vande Stouwe RA, Lange M, et al:  T-lymphocyte subpopulations in homosexual men . N Engl J Med 1982;;307:729-731.
Ammann AJ, Abrams D, Conant M, et al:  Acquired immune dysfunction in homosexual men: Immunologic profile . Clin Immunol Immunopathol 1983;;27:315-325.

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References

Gottlieb MS, Schroff R, Schanker HM, et al:  Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: Evidence of a new acquired cellular immunodeficiency . N Engl J Med 1981;;305:1425-1431.
Masur H, Michelis MA, Green JB, et al:  An outbreak of community-acquired Pneumocystis carinii pneumonia . N Engl J Med 1981;;305: 1431-1438.
Small CB, Kelin RS, Friedland GH, et al:  Community-acquired opportunistic infections and defective cellular immunity in heterosexual drug abusers and homosexual men . Am J Med 1983;;74:433-441.
Pitchenik AE, Fischl MA, Dickinson GM, et al:  Opportunistic infections and Kaposi's sarcoma among Haitians: Evidence of a new acquired immunodeficiency state . Ann Intern Med 1983;; 98:277-284.
 Pneumocystis carinii pneumonia among persons with hemophilia A . MMWR 1982;;31: 365-367.
Spero JA, Lewi JH, Van Thiel DH, et al:  Asymptomatic structural liver disease in hemophilia . N Engl J Med 1978;;298:1373-1378.
Gomperts ED, Lazerson J, Berg D, et al:  Hepatocellular enzyme patterns and hepatitis B virus exposure in multitransfused young and very young hemophilia patients . Am J Hematol 1981;;11:55-59.
Boyum A:  Ficoll-Hypaque method for separating mononuclear cells and granulocytes from human blood . Scand J Clin Lab Invest 1968;;21 ( (suppl 97) ):77.
Oppenheim JJ, Schecter B:  Lymphocyte transformation , in Rose NR, Friedman H (eds): Manual of Clinical Immunology . Washington, DC, American Society for Microbiology, 1976;, pp 81-94.
Schroff RW, Food KA, Billing RJ, et al:  Immunologic classification of lymphocytic leukemias based on monoclonal antibody-defined cell surface antigens . Blood 1982;;59:207-215.
 Update on acquired immune deficiency syndrome (AIDS) among patients with hemophilia . MMWR 1982;;31:644-652.
Ragni MV, Spero JA, Lewis JH, et al:  Acquired immunodeficiencylike syndrome in two hemophiliacs . Lancet 1983;;1:213-214.
Davis KC, Horsburgh CR, Hasiba U, et al:  Acquired immunodeficiency syndrome in a patient with hemophilia . Ann Intern Med 1983;;98: 284-286.
Poon M-C, Landay A, Prasthofer EF, et al:  Acquired immunodeficiency syndrome with Pneumocystis carinii pneumonia and Mycobacterium avium—intracellular infection in a previously healthy patient with classic hemophilia . Ann Intern Med 1983;;98:287-290.
Elliott JL, Hoppes WL, Platt MS, et al:  The acquired immunodeficiency syndrome and Mycobacterium avium—intracellular bacteremia in a patient with hemophilia . Ann Intern Med 1983;;98:290-293.
Weintraub P, Ammann AJ, Abrams DI, et al:  Altered T-cell immunity in hemophiliacs receiving frequent factor VIII concentrate . Blood 1982;;60:244a.
Lederman MM, Ratnoff OD, Scillian JJ, et al:  Impaired cell-mediated immunity in patients with classic hemophilia . N Engl J Med 1983;;308:79-83.
Menitove E, Aster RH, Casper JT, et al:  T-lymphocyte subpopulations in patients with classic hemophilia treated with cryoprecipitate and lyophilized concentrates . N Engl J Med 1983;; 308:83-86.
Jones P, Proctor S, Dickinson A, et al:  Altered immunology in hemophilia . Lancet 1983;; 1:120-121.
Goldsmith JC, Moseley PL, Monick M, et al:  T-lymphocyte subpopulation abnormalities in apparently healthy patients with hemophilia . Ann Intern Med 1983;;98:294-296.
Saidi P, Kim HC, Raska K:  T-cell subsets in hemophilia . N Engl J Med 1983;;308:1291-1292.
Landay A, Poon M-C, Abo T, et al:  Immunologic studies in asymptomatic hemophilia patients . J Clin Invest 1983;;71:1500-1504.
Luban NLC, Kelleher JI, Reaman GH:  Altered distribution of T-lymphocyte subpopulations in children and adolescents with hemophilia . Lancet 1983;;1:503-505.
Stahl RE, Friedman-Kien A, Dubin R, et al:  Immunologic abnormalities in homosexual men: Relationship to Kaposi's sarcoma . Am J Med 1982;;73:171-178.
Kornfeld H, Vande Stouwe RA, Lange M, et al:  T-lymphocyte subpopulations in homosexual men . N Engl J Med 1982;;307:729-731.
Ammann AJ, Abrams D, Conant M, et al:  Acquired immune dysfunction in homosexual men: Immunologic profile . Clin Immunol Immunopathol 1983;;27:315-325.

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