Cytotoxic antibody in acute myeloblastic leukaemia during immunotherapy: lack of tumour specificity.

Cytotoxic antibodies to antigens specific for leukaemic myeloblasts have been sought in the serum of patients with acute myeloblastic leukaemia treated by immunotherapy with irradiated allogeneic myeloblasts and BCG. Assays of complement- and K-cell-mediated activity were used. Cytotoxicity to allogeneic myeloblasts was detected in both assays. When sera from 15 patients, taken at various times during immunotherapy, were systematically tested against a panel of 5 myeloblasts, the following patterns emerged: 1. No antibody was cytotoxic against all myeloblasts of the panel in either the K-cell or complement-dependent assay. However, all myeloblasts of the panel were lysed by a number of sera. 2. Cytotoxic antibody was detected as often against a panel of lymphocytes from healthy donors as against the panel of allogeneic myeloblasts. 3. Fresh and cryopreserved myeloblasts were equally susceptible to lysis in both assays. 4. Experiments failed to demonstrate any deterioration of cytotoxic antibody on storage. 5. The number of K-cell-revealed cytotoxic antisera increased with length of immunotherapy. This pattern was not apparent for antibodies revealed by complement. 6. No instance of cytotoxicity in either assay was seen when serum was tested against 12 autologous myeloblasts. It is considered that cytotoxic antibody detected with allogeneic myeloblasts is probably directed against HLA antigens common to immunizing and test target myeloblasts and target lymphocytes.