The purpose of this study was to determine (1) the number and activity of natural killer (NK) cells in children with acute leukemia at different stages of their disease; and (2) the effect of interleukin-2 (IL-2) in enhancing NK activity of these patients' cells. The mean percentage of Leu 11+ NK cells in patients at diagnosis (5% of peripheral blood (PB) mononuclear cells) was significantly lower than for patients on maintenance (23%), post-treatment (21%) and for normal children (20%). The mean PB NK cell cytotoxicity for patients at diagnosis (16% lysis versus K562) and during maintenance (20%) was significantly lower than for post-treatment (41%) and normal controls (40%). After NK cells were incubated for 5 days with IL-2, NK cells from 82% (36/44) of patients showed enhanced cytotoxicity toward K562 and several acute leukemia cell lines as well as toward autologous leukemic cells. Cytotoxicity toward autologous cells was very low (0% to 5%, 16 hour assay) before IL-2 stimulation, and significantly increased (23% to 69%) after stimulation, suggesting that IL-2 may be a useful agent for enhancing the antileukemic immune response.
POEMS syndrome should be considered among the differential diagnoses of all patients with a bilateral papilledema in which no other cause can be readily elucidated.
Figure 1. Top left, Photograph showing facial features associated with Job's syndrome, or hyperimmunoglobulin E syndrome: deep-set eyes, broad nasal bridge, wide-fleshy nasal tip, mild prognathism, and ocular hypertelorism. Top right, Photograph showing dental abnormalities associated with Job's syndrome: retention of primary teeth with double rows of teeth. Bottom left, Photograph showing the appearance of the skin: xerosis, hyperkeratosis, eczematous plaques, and onycholysis. Bottom right, CT scan of the abdomen and pelvis reveals multiple loculated fluid collections and fat stranding.
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