The incidence and possible clinical relevance of immune complexes in sera from children with acute leukemias was investigated. Determinations were made in sera obtained at three-month intervals from individual patients over a two-year period. Two tests, the Clq binding and the polyethylene glycol precipitation assays, were employed. At time of diagnosis, immune complexes were found in sera from 6 of 41 patients (15%) with acute lymphoblastic leukemia (ALL). Three of 6 patients with T-cell leukemia had immune complexes at diagnosis as compared to 3 of 35 with null-ceH leukemia. Only 1 of the 6 patients with T-cell leukemia had a white blood cell count of less than 50,OOO/pl3. Of the patients followed for six months or more, 34% had immune complexes during therapy and the incidence of relapse was unrelated to the presence or absence of immune complexes. Fifty-two percent of patients that remained in remission during the period of study and 5 of 8 patients that relapsed (63%) had immune complexes at one time or another suggesting that the presence of immune complexes by themselves did not portend either a favorable or an unfavorable prognosis. Sera taken at the time of diagnosis from children with acute non-lymphoblastic leukemia (ANLL) had a higher incidence (36%) of immune complexes than similar sera from ALL patients (15%). Antibodies in sera from leukemia patients at diagnosis had a lower capacity to bind a BCG antigen than did sera from contfol subjects. Eleven of 17 patients that had BCG immunotherapy had a humoral antibody response to BCG. There was no relation between an antibody response to BCG and a favorable clinical response.
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