Lymphocyte blastogenesis to human leukemia cells and their relationship to serum factors, immunocompetence, and prognosis.

Lymphocyte blastogenic studies to autologous leukemia cells were carried out in 35 patients with adult acute leukemia. The effects of serum on this response and correlation with studies of general immunocompetence were studied. Twenty-five of 35 patients had positive blastogenesis. Nine patients with acute myelogenous leukemia had complete or partial abrogation of this response in autologous serum. Five patients had facilitation of the blastogenic response in autologous serum compared to the response in allogeneic serum. Patients with acute myelogenous leukemia had a more vigorous response to their leukemia cells than patients with acute lymphoblastic leukemia. Although studies of general immunocompetence tended to correlate with the in vitro response to leukemia cells, only one patient who was unresponsive to autologous leukemia cells was immunoincompetent. A good prognosis was correlated with a vigorous response to leukemia cells, inhibition or facilitation of that response by autologous serum, and a persistently positive blastogenic response in remission.