The role of the mature neutrophil in bacterial infections in acute leukemia.

By RICHARD T. SILVER, GRACE A. BEAL, MARVIN A. SCHNEIDERMAN AND NORMAN B. MCCULLOUGH T HE natural history of acute leukemia is characterized by the developnsemst of frequent and severe bacterial infections. This suggests that susceptibility to infection may be related to impaired cellular or hunsoral mechanisms of host resistalice, a consequence of the marked derangement of the hensatopoietic systens us this disease. Although measurements have previously beeli made of certain factors of cellular defense against imsfection in patients with acute leukemia, the reports are (onflictilsg. While Hirschberg’ fouisd that phagocytosis was impaired its acute leukemia, Braude et al.,2 Struinia and Boerner,3 aisd Jersild4 observed that the phagocytic activity of the mature iseutrophil iii leukemic individuals was isormal. Braude et al. stated that us acute leukemia the susceptibility of certaiis patieists to bacterial infectiois was a fuisction of a marked decrease its number of nsature neutrophils, rather than a decrease iii phagocytic functiois of the individual cell. However, other authors’ ‘ have recorded the developnsent of severe bacterial infections whemi the absolute mature neutrophil count was high (due to high total white blood cell count). Our own clinical observatioiss have confirmed this; conversely, we have observed that sonse leukemic patients, with relatively low mature neutrophil counts, do isot appear to be extraordinarily susceptible to infectiois during various phases of their illness.