SERUM FACTORS OF ACQUIRED HEMOLYTIC ANEMIA IN LEUKEMIA AND LYMPHOMA*

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Abstract
The purpose of this study was to determine whether or not the erythrocyte coating globulin found in the serums of patients with acquired hemolytic anemia could be characterized as erythrocyte antibody using the technique of immune adherence. This method was chosen because immune adherence occurs only as a consequence of an antigen-antibody reaction and would not occur if the globulin was not erythrocyte antibody. Serums obtained from lymphoma and leukemia patients with an indirect Coombs positive reaction were compared im-munologically to ABO-specific isologous and heterologous erythrocyte antibody. The technique consisted of incubating serial dilutions of test serum with known concentrations of human red cells, human complement, and freshly washed guinea pig platelets. Immune adherence of red cells to the indicator platelets developed in the presence of complement and red cell antibody. This produced both macroscopic and microscopic flocculation of the red cells. It was found that either type of group specific erythrocyte antibody reacted strongly in immune adherence with normal red cells in this system. Coombs positive red cells from patients with lymphoma and leukemia also reacted strongly in immune adherence in the presence of rabbit antihuman globulin. These reactions did not take place in the absence of complement. In contrast, Coombs indirect positive serums from non-transfused patients with acquired hemolytic anemia did not react in immune adherence with either their own or group compatible homologous erythrocytes. These studies demonstrate that in these patients with lymphoma and leukemia the erythrocyte coating globulin of acquired hemolytic anemia is not characterized as erythrocyte antibody by the immune adherence technique. It is believed that these abnormal globulins, with affinity for the red cell surface, are non-immunologic and may represent a form of dysprotein-emia.