The humoral immune response to endotoxin in patients with leukemia and myelodysplastic syndrome

Abstract

The purpose. Investigate the antiendotoxin immunity in patients with leukemia and myelodysplastic syndrome. Methods. We examined 257 patients with acute myeloid leukemia (AML, n=70), chronic myelogenous leukemia (CML, n=75), myelodysplastic syndrome (chronic myelomonocytic leukemia – CMML, n=23; refractory anemia with excess blasts – RAEB, n=18) and B-cell chronic lymphocytic leukemia (B-CLL, n=71). The control group included 37 healthy people who have not a history of any chronic disease, and the clinical manifestations of acute diseases were absent at the time of the survey. By sex and age, the control group of healthy people matched to a groups of patients with leukemia and myelodysplastic syndrome. Levels of serum antibody classes A, M and G to endotoxin (anti-ET-IgA, anti-ET-IgM and anti-ET-IgG) were determined by ELISA. The concentration of total immunoglobulin classes A, M and G in the blood was determined by immuno turbidimetry. Results. It was found that before treatment in patients with CML, CMML, RAEB and B-CLL levels of serum anti-ET-IgA and anti-ET-IgM were significantly reduced. The only exceptions were patients with AML in the first acute stage of the disease (AML-AS) levels of anti-ET-IgA were not significantly different from the normal values​. However, the levels of serum anti-ET-IgG in patients of these groups were either significantly higher (patients with AML-AS, CML in accelerated phase and CMML), or not different from the normal values (patients with RAEB and B-CLL). Under clinical remission in patients with AML and CLL showed a significant increase in the levels of serum anti-ET antibodies of all classes, while in patients with CML in chronic phase alone significantly increased levels of anti-ET-IgM, and the content of the anti-ET antibodies other classes were not significantly changed. The direction of changes in the levels of anti-LPS antibodies often do not coincide with the trend of changes in the concentration of immunoglobulins in the blood of the same classes. Any significant correlations between these parameters are not found. Conclusion. The results should be considered in a personalized approach to treatment and immunorehabilitation patients with these diseases.