THE MONOCYTE TUMOR-NECROSIS-FACTOR-ALPHA PRODUCTION IN PATIENTS WITH ACUTE-LEUKEMIA IN COMPLETE REMISSION

Tumor necrosis factor-alpha (TNF-alpha) production by unstimulated and lipopolysaccharide (LPS)-stimulated peripheral monocytes has been stu died in 17 acute myeloid leukemia (AML) patients, 54 AML patients in c omplete remission (AML-CR), 9 acute lymphoblastic leukemia (ALL) patie nts and 13 ALL patients in complete remission (ALL-CR). TNF-alpha prod uction by the unstimulated monocytes in ALL patients (n = 6, mean: 6.6 +/- 4.9 u/ml) was higher than that of normal controls (n = 13, 0.9 +/ - 0.7 u/ml), AML patients (n = 14, 2.0 +/- 2.1 u/ml) and AML-CR patien ts (n = 21, 1.4 +/- 1.2 u/ml). TNF-alpha production by the LPS-stimula ted monocytes of the AML-CR patients (n = 54,12.4 +/-13.4 u/ml) was si gnificantly higher than that of the normal controls (n = 21, 3.5 +/- 2 .5 u/ml) and the AML patients (n = 17, 2.6 +/- 2.4 u/ml), p < 0.01, bu t there were not any significant differences among the AML-CR patients and the ALL patients or the ALL-CR patients. We separated the AML-CR patients into 3 groups, depending on the length of their remission, an d found that AML-CR patients with longer than 6 months (M) but less th an 60 M (n = 21,15.7 +/- 16.9 u/ml) and the patients with a remission longer than 60 M (n = 11, 18.2 +/- 15.9 u/ml) had significantly higher TNF-alpha production than that of the controls. The AML-CR patients c ould be separated into a high TNF value group (n = 21), in which TNF-a lpha production had increased from the normal levels to higher levels than the normal or showed a sustained higher level, and a normal TNF-a lpha value group (n = 13), in which TNF-alpha production had decreased from the higher level to the normal level or showed a continuously no rmal level. 7 out of 14 AML-CR patients in the normal group and only o ne out of the 21 AML-CR patients suffered a relapse. In AML-CR patient s, monocyte TNF-alpha production was possibly related to the prognosis of the AML-CR patients, and careful observation of the disease will b e necessary as TNF-alpha production of LPS-stimulated monocytes sponta neously decreases.