A MORPHOLOGIC AND IMMUNOLOGICAL STUDY OF THE LARGE GRANULAR LYMPHOCYTE IN NEUTROPENIA WITH T-LYMPHOCYTOSIS

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  • 1 January 1984
    • journal article
    • research article
    • Vol. 63  (5) , 1133-1140
Abstract
Four patients with expansion of a unique population of lymphocytes that is consistently associated with neutropenia are reported. Two patients also had rheumatoid arthritis and autoantibodies. The lymphocytes contained many cytoplasmic azurophilic granules, which possessed strong acid phosphatase activity. Multiple cytoplasmic parallel tubular arrays were observed ultrastructurally. These granular lymphocytes showed the T suppressor/cytotoxic cell phenotype (E+, OKT3+, OKT8+, OKT4-, OKM1-, OKl1-) and exhibited antibody-dependent cell-mediated cytotoxic activity but little or no natural killer cytotoxicity. They did not respond to recall antigens, concanavalin A or pokeweed mitogen, but the cells from 1 patient did respond to phytohemagglutinin. No in vitro suppressor cell activity on mitogenic responses of allogeneic cells and on mixed lymphocyte cultures could be demonstrated. There was evidence of suppression of Ig synthesis in vivo. It is uncertain that the expansion of this subset of lymphocytes represents a leukemic process. Their constant association with neutropenia, however, raises the possibility that the increase in large granular lymphocytes and neutropenia might be pathogenetically related.