Effects of cyclosporin A on refractory B-cell chronic lymphocytic leukemia

This report details the effects of cyclosporin A (Cs-A) on the clinical cou rse of B-cell chronic lymphocytic leukemia (B-CLL) with an increase in circ ulating T cells that express CD3, CDS, CD25, CD45RO, and T-cell receptor al pha beta chain. Cs-A was used for treatment of a female patient with refrac tory B-CLL and was shown to increase dramatically the number of leukemic B cells in association with a simultaneous increase in T cells in vivo. To st udy this effect more precisely, CD19(+) (B cells) and CD3(+) (T cells) cell s were isolated from the patient and cultured in the presence or absence of Cs-A. When Cs-A was added to the culture, no cell stimulation was seen. Ho wever, CD3(+) cells from the patient underwent cell death, relative to thos e from healthy donors. On the other hand, CD19(+) cells from the patient we re more resistant to Cs-A than those from healthy donors. Because in vitro experiments cannot explain this phenomenon of Cs-A increasing leukemic cell s (not only B-CLL cells but also T cells), care should be exercised in the clinical use of Cs-A in B-CLL patients. (C) 2000 The Japanese Society of He matology.