REACTIVITY OF RED CELL ELUATES AND SERUMS IN PATIENTS WITH ACQUIRED HEMOLYTIC ANEMIA AND CHRONIC LYMPHOCYTIC LEUKEMIA*

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Abstract
Tne purpose of this study was to further define the immunologic characteristics of Coombs positive patient red cell eluates and serums of acquired hemolytic anemia (AHA) to chronic lymphocytic leukemia by determining whether these substances are related to and reactive with autologous neoplastic lymphocytes. The sensitive technique of immune-adherence (IA), to which an antigen microscopically adheres to an indicator (either primate red cell or non-primate platelet) only to the presence of complement and specific antibody, was used to this investigation. As a prototype experiment heterologous antibody to human neoplastic lymphocytes was produced by injecting them into albino rabbits. Eluates were obtained by acid elution and kept their ability to resensitize normal, type O, Rh negative red cells. When heterologous lymphocyte antibody, Coombs positive patient red cell eluates and serums were reacted with neoplastic lymphocytes IA of the lymphocytes to the indicator particle occurred to all three instances indicating an antigen-antibody reaction. No IA occurred when, as a control, the eluates and serums were reacted with autologous red cells. The observations suggest that these materials, implicated to the pathogenesis of this type of AHA, may not be related to erythrocytes but, what is more significant, appear to result from abnormal antibody synthesis stimulated by autoantigenic leukemlc lymphocytes. This concept is to accord with the lympholytic and ameliorative effects of the adrenocortical steroids to the treatment of this disorder.