From www.bloodjournal.org by guest on June 18, 2017. For personal use only.
The
Role
of
the
Mature
Neutrophil
in
By
T.
RICHARD
SILVER,
HE
natural
history
of frequent
to infection
and
may
of acute
certain
factors
mia,
the
reports
are
observed
that
the phagocytic
was isormal.
Braude
crease
its number
of the
functiois
developnsent
count
have
patients,
ordinarily
Recent
activity
confirmed
However,
leukocyte
this;
amsd
phase
in the
Kohn8
questioised
result
amid
niajority
Severe
of
the
whether
not
the
with
of
the
leukemia,
Institute,
mssade
and
have
study,
observations
iii
leukemic
leukemia
the
suscepti-
of a marked
mature
neutrophils
organisms
by
are
been
to
mature
given
March
the
2 to 196 days.
the
1)iseases,
the
National
National
sonse
leukemic
isature
of
at
the
the
and
its relation
Luhby’
reported
remissions.
that
al.’
aisd
Bassen
amid Luhby
et
and
were
observed
a high
iisfections
of bacterial
in
Clinical
the
us
that
or low
leukocyte
of the
infection.
was
patients
Cemster,
with
As
number
The
Cancer
part
of this
of circulating
Phagocytosis
studied.
acute
National
comnsunication.9
relationship
in vitro
made
March
median
Cancer
imifections
of Brucella
results
these
of
imsvesti-
paper.
were
and
of
discussed
peripheral
leukopenia
the leukopeisic-hypoplastic
with
in another
onset
amid
Biernsais
year
reported
of
relationship
has beeis
developed
the
on
made
in this
1955
the
gramsulocytopenia.
past
iseutrophils
observations
15,
recorded
mature
neutrophil
own clinical
obserthat
by Diansoisd
leukopenia.
METHODS
1. Clitsical
de-
phagocytic
iii
have
‘
partial
noted
infection
during
were
and
infections
the
were
Jersild4
iseutrophil
observed
a marked
antedated
“complete”
the
cause
acute
have
was
aisd
a decrease
Diansoisd
by
infectiois
leukemia
tious
authors’
coumsts.
preceded
a marked
From
other
attention
to the
oisset of infectiots
couist,
amsd w’ith or without
Detailed
clinical
observatioiss
from
than
of
leuke-
phagocytosis
Boerner,3
a fuisction
rather
we
conversely,
graisulocyte
was characteristically
of the niarrow.
hypoplasia
between
was
acute
low mature
neutrophil
counts,
do isot appear
to be extrato infectiois
during
various
phases
of their illness.
have
directed
leukemia.
The
us acute
remission
gations
infectiois
of host
hensatopoietic
beeli made
with
that
and
mature
us acute
that
neutrophils,
cell.
the
stated
mechanisms
fouisd
Struinia
of
et al.
to bacterial
individual
reports
rensissioms
children
al.,2
developnsemst
susceptibility
of the
previously
in patients
Hirschberg’
et
the
that
or hunsoral
imsfection
While
nsature
with relatively
susceptible
total
by
suggests
of severe
bacterial
infections
whemi the absolute
high (due to high total white
blood
cell count).
Our
was
vatioiss
to
of
This
cellular
Braude
patieists
SCHNEIDERMAN
is characterized
against
(onflictilsg.
leukemia,
of certaiis
A.
MARVIN
infections.
defense
its acute
bility
leukemia
to impaired
impaired
individuals
BEAL,
of the marked
derangement
Although
measurements
have
of cellular
Infections
B. MCCULLOUGH
bacterial
be related
resistalice,
a consequence
systens
us this disease.
A.
NORMAN
severe
Bacterial
Leukemia
GRACE
AND
T
Acute
in
on
1, 1956.
being
Institute
Institutes
AND
MATERIALS
thirty-six
The
88 days.
and
patients
period
The
the
of Health,
diagnosis
National
Bethesda,
814
with
of observation
of acute
Institi,te
Md.
active
for
acute
each
leukemia
of
Allergy
let,kemia
patient
ranged
was
and
made
Infec-
in
From www.bloodjournal.org by guest on June 18, 2017. For personal use only.
it.
I. SILVER,
G.
A.
BEAL,
M.
A.
SCHNEIDERMAN
ANt)
N.
B.
815
MCCULLOUGH
each case by examination
of the bone
marrow
aspiration
with
supravital
and
fixed
preparations employing
Janus
green and Giemsa
stains
respectively
. The
bone marrow
criteria
used
to classify
the activity
of the disease
were
those
accepted
by the Clinical
Studies
Panel
of
the Cancer
Chemotherapy
National
Service
Center.’#{176} Hemoglobin,
platelet
coumst
, leukocyte count
and differential
were performed
routinely
three
times
weekly
. The
total
white
blood
cell count
was determined
after
filling
both
chambers
of a standard
hemacytometer
from one pipet
and counting
the cells in the four
large
squares
of each
chamber.
A smear
of the
peripheral
blood
was
prepared
with
Giemsa
stain,
and
200
cells
were
counted
the differential.
(When
the total leukocyte
count
was 200/Cu.
mm or less, only
counted.)
The diagnostic
methods
employed
to determine
bacterial
infection,
fections
encountered
are reported
in a separate
communication.9
Drugs
used
ment
of acute
leukemia
pteroylglutamic
related
steroids.
Phagocytic
and
were
(0.8%
was
which
use
man
The
studies,
agar
Test
the
at
The
test
i.e.,
previous
the
were
made
showed
In
second
part
II, the
part
titration
test
run
past
showed
one
in
contained
no
Parallel
the serum
from
prior
to
cap
vial;
its
presence
citnated
of live,
blood
virulent
to graded
Bru-
amounts
of
study.
tenfold
be
blood.
By
undiluted,
means
added
37 C. incubator
whole
citrated
test
of
and
a
after
with
readily
the
was
a modification
supply
use.
For
been
when
Brucella.
use
in
were
a Brucella
made
and
serologic
in
of
the
pipet
dilution,
the
the
dusning
were
tested
The
final
concentration
that
of
intervals
to
the
immune
other
series,
ml.
of
serum,
serum
X
transferred
of
series
received
serum
the
for
bleeding
by
orgamsisms
foimr
years,
in the frozen
and maintained
at
5
C. The
serum
1:640.
using
12 X
Brucella
of immune
was
to
of
Jersild’2
past
stored
due
control
Brucella
thawed
as (liluemit
provided
0.001),
to
by
was
tests
titer
immune
the
over
between
immune
that
obtained
exposed
of
and
described
periodically
immune
opsonins
the
was
anti-
the
absence
blood
The serum
specimen
present
study,
it was
0.1 ml. of a standard
suspension
for thirty
minutes.
To the appropriate
leukemic
blood;
the parallel
series
blood.
the
method
continuously
blood
proper
of
Brueella
serum
agglutinin
(0.2
in
while
of the
affect
indi-
the
in
leukemic
of immune
was
not
citrated
leukocytes
possessed
the
whole
was
by
both
Brucella
did
brucellosis-negative
culture
Brucella,
A stock
storage
test:
leukocytes
that
undertaken.
for
patient
bacterial
I, the routine
leukocytes
a normal
patient
was
ability
the
phagocytized
indicated
had
of
from
normal
of
parts.
Its part
to phagocytize
two
leukocytes
concentration
parallel
by
blood,
blood
the
leukemic
whose
out in
of
the
test
dilutions
leukemic
carried
that
It had
preservative.
serum,
citrated
in phagocytic
assure
who
and
phagocytic
screw
was
by exposure
blood
phagocytosis
the
technician
month
in a sterile
whole
sensitized
and
procedure
years
ten
marked
this
opsonins.
research
the
patient’s
in the
that
would
no
of
Brucella
of
a healthy
steroids.
of the
subject
to
Brucella
When
control
the
whole
was
exposure.)
normal
received
prior steroids,
When
retests
were
occurred.
incubated
was
ability
the
and would not be phagocytized
It also indicated
whether
the
serum.
tube
procedure
indicated
controls
test
state,
state
use
measuring
brucellosis-immune
(This
control
structurally
5 C.
tests
Two
a known
for
for
Preliminary
phagocytosis.
did,
forty-eight
stored
technic”
vidual.
not
other
The Brucella
culture
selected
recently
isolated
from a hubefore
its use in this study.
was two)
. For
use in the
hour
growth
on liver
agar
at 37 C. was
suspended
in
with the aid of a Fisher
electrophotometer
to an estimated
the intervals
between
tests,
the culture
was maintained
and adjusted
per ml. During
slants
employed.
genie
previously
culturefor
procedure.
Huddleson
of
had been
ofBrucella
physiological
saline
25 X 10 organisms
liver
of
and
had
in-
in
highly
virulent
strain
of Brucella
abortus
The guinea
pig infectivity
was determined
just
less than
ten viable
organisms
(actual
determinatiots
phagocytic
b)
wiso
consisted
citrate)
cortisone
remission
administration
employed
a smooth,
was
infection.
ID
was
on
prior
patients
hematologic
were
the
the treat4-amino-N’#{176}-methyl
6-mercaptopunine,
and
and
serum.
Preparation
a)
no
of sodium
brucellosis-immune
for
in ten
or
system
were
corticotropin,
performed
also
concentration
organisms
period
,
infection
phagocytic
final
cella
were
when
there
2. The
this
(methotrexate)
studies
repeated
performed,
during
acid
to obtain
50 cells
0.02
100
and
ml.
in
the
l)y
volumes
mm. glass
the tubes
was
then
a similar
in the
of
were
immune
To
each
placed
0.1 ml.
quantity
series,
control
tubes.
added
tubes
one
normal
of
was 1:10,
in
of the
normal
1:100,
From www.bloodjournal.org by guest on June 18, 2017. For personal use only.
816
MATURE
and
1 : 1000.
NEUTROPHIL
In some
IN
instances,
for an additional
thirty
BACTERIAL
a dilutioms
minutes
INFECTIONS
of 1 : 10,000
with
periodic
out
by
the
procedure
cytophagic
c)
developed
ACUTE
The
LEUKEMIA
tubes
of the tube
were
contents
re-incubated
at least
three
period
blood
smears
were prepared
using
a
from each tube.
Prompt
drying
of the films
Fixing
and staining
of the smears
was carried
McCullough
and
Dick”
for
use
in
the
Brucella
opsono-
test.
Measurement
ically
by
tested.
was
mixing
times.
Immediately
following
the incubation
separate
capillary
pipet
to remove
samples
was facilitated
by the use of a flow of warm air.
IN
and
of degree
the
number
of phagocytosis.
of
The
Brucella
stained
ingested
per
smears
leukocyte
were
examined
was
counted
microscopfor
a
total
of 25 leutkocytes.
It was observed
that
in a given
phagocytic
preparation,
the
degree
of
phagocytosis
of individual
mature
neutrophils
was relatively
constant.
Based ous the method
by Huddleson,
total
phagocytic
activity
of the
preparation
was
thus
graded
as
follows:
leukocytes
which
had
ingested
forty
or more
Brucella
were
graded
as showing
3+
phagocytosis;
those
which
contained
20-40 organisms
as showing
2+ phagocytosis;
those
which
contained
1-20
Brucella
as showing
1+ phagocytosis;
leukocytes
which
contained
no Brucella
Mature
were
graded
neutrophils
were
defined
as
as zero.
were
Only
defined
mature
as
metamyelocytes,
neutrophils
band
and
myelocytes,
were
segmented
included
in the
forms.
progranulocytes
and
examination.
Immature
neutrophils
myelohlast
s.
RESULTS
Table
1 records
patients
count
the
the
in whom
and
age,
the
differential
phagocytic
the
on the
tests
sex,
phagocytic
during
day
the
test
infection
Data
hematologic
were
of the
severe
1.-Clinical
TABLE
and
studies
Pertaining
diagnoses
performed.
are given.
in two
The
It was
patients
to Phagocytic
of the
ten
blood
cell
white
possible
with
to repeat
active
hemato-
Studies
Differential
N
1
Ag
sC
3
M
Type
leukemia
Lymphocytic
2
8
M
Lympho-
3
6
F
Lympho-
cytic
cytic
Status
leukemia
of
B
Clinical
infection
#{149}
_______
WBC
X 10’
-
Active
None
3.5
10
89
1
Remission
None
4.5
38
57
4
Active
None
3.1
3
Remission
None
2.4
63
34
0
3
1.3
16
82
0
2
7
Remission
None
Remission
Cellulitis
Active
None
50.0
Active
None
4.8
46
Active
None
11.1
15
Active
Pyelone-
15.2
2
Ps.
aerugi-
1
67 30
nose
4
7
F
Lympho-
93
cytic
5
22
M
Lympho-
9
6
6
25
7
1
cytic
6
34
F
Lympho-
2
3638
1
15 81
7
2
1
7
3
cytic
7
49
F
Lymphocytic
E.
coli
1
phritis
Active
Pharyngitis
Ps.
aerugi-
0.68
37
9.4
67
63
nose
8
47
M
Remission
None
Granulo-
Active
None
cytic
Active
Cellulitis
127.0
Ps.
aerugi-
4
32
7112
1.0
16
28 48
43
13
8
nose
Partial
9
47
M
Granulo-
Remission
Active
None
None
1.4
3.9
29
52
Active
None
2.6
26
64
cytic
10
28
F
Granulo-
241
30
1
cytic
#{149}
Key:
SN-segmented
myeloblast;
L-normal
E-Eosinophil;
B5-Basophil.
neutrophils;
lymphocyte;
BdN-banded
AL-abnormal
neutrophils;
immature
MM-metamyelocyte;
lymphocyte
M-myelocyte;
(“lymphoblast”);
M-monocyte;
MB1-
1
From www.bloodjournal.org by guest on June 18, 2017. For personal use only.
H. T.
logic
SILVER,
disease
(Nos.
hematologic
3),
infection
patients
3+,
immune
In
ims oise
the
did
contain
its patiemst
iso
seven
of
immumse
mature
neutrophils
phagocytosis.
to
additioms
from
leukemic
0.002
ml.
of
B.
dunimig
imsfection
partial
or
patients
(Nos.
5, 9,
of
insnsune
The
total
test
and
amount
was
Ims patietits
the
Brucella
addition
methotrexate
for
amid
immune
tisl.
had
beets
0 to 61 Gm.
of 6-mercaptopurine
Relationship
of Mature
The
opsonocytophagic
previous
impressions
neutrophils
mine
was
next
the
the
mature
as
to each
employed
in
by
impaired
in acute
leukemia.
of bacterial
neutrophil
counts
FREQUENCY
MEDIAN
in the
OF
our
neutro-
of each
Amouists
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phago-
ranged
from
Leukemia.
of tests
corroborated
normal
seemed
patients
mature
reasonable
with
to
acute
RELATED
COUNT
deter-
leukemia
DURING
TO
PERIODS
PATIENTS)
II
(-3
4
day
series
INFECTION
(34
amid
patiemits
blood.
NEUTROPHIL
INFECTION
3+
of 6-mercaptopurine
test.
in
It
peripheral
its two
by mature
morphologically
in
BACTERIAL
MATURE
OF
infections
the
showed
1+
the
I
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II
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600
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NEUTROPHILS
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1
the
of methotrexate.
to Infection
phagocytosis
its
in leukemic
amounts
1 Gm.
that
relation
FREE
Count
system
not
prior
0 to
in
serum,
comitrols
to
Varying
administered
amid
phagocy-
mion-imumutie
insnsune
phagocytosis
received
patient.
Neutrophil
10,
had
from
imicubated
of
normal
seruni,
drug
every
10)
(sera
9 and
were
of 0.02
patients
of antimetabolite
calculated
comsiplete
serum
blood
cytic
complete
during
was 3+ in five patients
amsd their
controls,
amid
and controls.
With 0.0002
ml. of immune
serum,
phagocytosis
phils
of leukemic
and
control
blood
was
1 + to 0.
control
817
MCCULLOUGH
1, 2, 3, 4, 6, 7, 8) amid its the
whets
the
N.
This compared
to :3-f- phagocytosis
in the ison-imnsuise
coistrol.
(Nos.
occurred
With
With
the
phagocytosis
serum.
severe
agglutinimss).
patients
phagocytosis
absence
with
5, 1 to 2+.
zero
ANt)
us four
patiemsts
1, 2, 7, 8). Three
brucella
and
remaining
controls,
SCHNEII)ERMAN
patient
and
prior
and
control
A.
(Nos.
phagocytosis
was
the
8),
M.
(No.
without
demonstrable
tosis
7,
BEAL,
remission
remissioms
these
G. A.
5000
DURING
10,000
PERIODS
to
From www.bloodjournal.org by guest on June 18, 2017. For personal use only.
MIS
M.TURE
As
13(’st
XEUTIRII’HIL
al.’’
et
leukemiiia
ill
IX
have
observed,
l)e(’ause
tieutrophil
(\IN)
phil
counts
and
without
skewed
were
proved
of
leukocyte
comisputed
bacterial
IX
ineami
distuibutioms.
amid median
MN)
-
INFECTIONS
coniputatioti
their
of
counts
(L
BA(’TEIIIAL
all
36
(Two
infectiomi.
LEUKEMIA
(OUtits
is
Therefore,
counts
for
A(’UTE
nsimius
patients
value
nsature
neutro-
the
had
little
nsature
the
for
patiemits
of
nsediats
DO
period
with
infectioms-free
periods.)
The
MN
median
touitit
infection-free
during
fect iots in the itidividual
with
lower
MN coumits
more
imifections
then
in periods
patietsts
prior
Serial
imifection was
preceded
ion.
of imifect
sevemiteen
higher
MN
of mature
counts.
The
of a proved
developnsent
free
per
eighteemi
patients
the
neutroplsils)
change
of inpatietits
develop
ims the
bacterial
MN
imsfertion
was
The
Although
neutrophil
following
for
of
ererj
decrease.
CHANGES
IN
TO
to
decrease
for
infection
it is to
be
was
emphasized
MATURE
BACTERIAL
a 50-So
eighteemi
infectiomi
mediams
bacterial
count,
that
the
to, during,
seventeeis
and following
of these
patietits,
($8
is expected)
the
thus
eighteems
preceded
by
that
itsfectioms
did
NEUTROPHIL
INFECTION
division
COUNTS
patiemsts
was
decrease
PRIOR
PATIENTS)
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333
NEUTROPHIL
MATURE
OF
Fmu. 2
COUNT
NEUTROPHIL
INFECTION
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miot imsvarial)ly
z
3.3
is
patiemits
the ratio
of the MN
the mediami
NM
count
iii the
Cl)
Iii
a
MN count
itsitiiediately
prior
to the
could
occur
due to chance
alotie
its
this
(assumimig
developnsemit
infection.
cent.
the
imi
that
2 depicts
F’igume
to
of
by a drop
probability
The
.0002.’
prior
peri()(l
develop
of
thami
coumit
tisatute
cent
correlated
hematologic
studies
were
available
prior
bacterial
imifectiois
in eighteen
patiemtts.
In
omiset
font
be
exaniimsed.
j)roved
less
the
per
with
the frequency
(fig.
1). This
indicated
that
in getieral
free of itifectiots
did not subsequeistly
miot
with
to
average
as the
could
patient
thami
itsimsiediately
count
(as well
periods
AS
COUNT
the
From www.bloodjournal.org by guest on June 18, 2017. For personal use only.
R.
T.
SILVER,
G.
A.
BEAL,
CHANGES
M.
IN
A.
SCHNELDERMAN
L..MN*COUNTS
INFECTION
($8
*L_MN:Total
ANI)
PRIOR
TO
N.
819
MccULLOU(;tI
B.
BACTERIAL
PATIENTS)
Ieukocyte
minus
mature
PERCENT
neutrophil
PERCENT
C,)
I-.
Docrscss
/ncr.os#{149}
ii,
$2
I-
/‘,
COUI7I
COUI1
-S.
.-
_____
U..
0
06
z
:
::.:...:::.
4
:
i
i
3.3
10
33.3
PRE-INFECTION
L-MN
I
L-MN
COUNT
$00
COUNT
DURING
PERIODS
FIG.
The
next
consideratiots
leukocytes
other
Prior
to
count
amid
chance
the
mature
had
rises.
s’as
six
per
cetst
this
itsfectiots,
The
The
is 0.24.15
Similar
probability
median
(fig.
that
currence
measured
sion.
by
Other
this
is not
only
was
not
that
were
during
the
true
this
had
divisiomi
for
all
were
made.
falls
its the
L-MN
could
occur
coutits
for
the
due
to
eighteen
‘USSION
employed
by
of
l3rucella
leuketisia
by
is
organisms
tsot
activity
by
impaired.
antimetahohite
with chatiges
active
hematologic
phagocytic
is based
phagocytosis
also
calculatiomis
its h-MN
altered
associated
either
that
impaired
ptieumococci
While
test
evidetice
leukemia
and
was
was
3).
phagocytosis
of itifectioms
OF MEDIAN
INFECTION
patiemits
decrease
This
experience
suggests
that
phagocytosis
neutrophils
in patiemits
with
active
acute
evidence
OF
relatiomiship
eleven
Dis
no
FREE
mseutrophils.
of proved
sevets
alone
patiemits
than
onset
000
PERCENT
3
whether
was
333
AS
tisature
There
therapy.
was
The
oc-
its phagocytic
activity
as
disease
or during
retiiis-
of nsature
neutrophils
the results
obtaitsed
whets
its the test systemu.’
miiature
mieutrophils
\\.iss
quatstified,
its acute
staphylococci
upots
observed
that
immature
cells of the granulocytic
amid lytuphocytic
series
displayed
no
sigmiiflcant
phagocytic
activity.
This
is its agreement
with
previously
published
results.24
Thus,
the developnsent
of bacterial
infection
appeared
to l)e preceded
by,
but
or more
(Neutropenia
leukensia
did
iiot
in the
tsecessarily
follow,
nsature
mseutrophil
of
degree
this
as a consequetsce
dyisamuic
counts
could
of either
have
the
decreases
amid
tiot
developed
disease
per
of the
by
chiamsges
during
order
of fifty
in other
the
se or atitituetabolite
course
per
cent
leukocvtes.
of
acute
therapy.)
From www.bloodjournal.org by guest on June 18, 2017. For personal use only.
820
MATURE
The
ituportaisce
of change
that
the
MN
with
the
nsediati
in acute
fection
IN
BACTERIAL
its the
coumit
INFECTIONS
\IN
counts
periods
iii
frequency
of bacterial
infections
ams iisdividual
iJN
not
necesrily
of
IN
its a given
could
or
value
for
be
This
.
low,
by
not
patient
high
LEUKEMIA
ensphasized
of imsfection
coumst,
prognostic
ACUTE
is further
free
leukemia,
is
future
NEUTROPHIL
fact
suggests
its a period
predictimsg
the
correlated
that
free
of its-
susceptibility
to
imsfection.
The
absolute
patieist
MN
to
levels
decreases
MX
count
patiemit
.
withiti
the
the
iti
Not
when
sanse
Thus,
bacterial
itifectiomis
more
it
omie
with
at
bacterial
count,
than
patiemsts
iti
developed
occurred
Although
tieutrophil
probably
eventually
imsfeetiots
patient.
mature
chamsges.
infectioms
infrequetstly,
not
preceded
invariably
accounts
for
from
different
was
infectioms
did
factor
acute
varied
significantly
by
follow
the
such
frequeticy
of
leukensia.9
SUMMARY
Its acute
leukemisia,
not
was
metabolite
The
ceded
by
blood.
to
developed
us the
decreases
the
54
development
In
of bacterial
leucemia
therapia
tioti
al
de
altere.
samsguine
de
mieutrophilos
matur
in comparation
comi
54 pro
Viste
esseva
philos
matur
implicate
cemia
ceisto.
its omne
in
reductiomses
ex
casos,
de
de
patient
was
to
msot
always
imme-
of infection.
follow
de-
play
also
acute
pre-
peripheral
coutsts
free
a role
leukemia.
mseutrophilos
nomi
infection
tsumero
de
atite
non
infectiomi.
sequeva
comichudite
infectiones
ab
con
bacterial
msumera-
un
patiente
leucemia
habeva
in
in
reducite
he declaration
altere
acute
matur
nu-
de
reduction
infecmedian
Ic reduction
que
per
be
mseutrophilos
be
se
alterate
variava
patietstes
de
matur
esseva
bacterial,
imsfectioms
dece-octo
hibere
de
from
period
in patientes
del
que infection
il debe
esser
he disveloppamento
per
immediatemente
he periodo
anti-
mature
leukemia
factors
organismos
bacterial
Dece-septe
by
in the
with
brucellas
iste
its stato
imifection
dynamic
peripheric.
nseratiomies
tiomi
per
de
vary
did
other
patients
periodos
matur
absolute
INTERLINGUA
de
de
o duramste
neutrophilos
precedite
IX
phagocytose
declaration
Le
in
The
neutrophil
to the
that
Iseutrophils
altered
iseutrophils
imifectioms
infections
he phagocytose
Le
a amitimetabolitos
absolute
esseva
le
acute,
imitacte.
As
it is suggested
mature
not
acute
mature
as compared
SUMMARIO
nionstrava
lower
cent.
to
with
of mature
had
per
neutrophils
found
was
isumber
of infection
was
decrease
its nsature
infection.
its patients
patients
onset
was
orgamsisms
of bacterial
infectioms
of eighteets
mediats
the
infection
by
orgatsisins
these
periods
of bacterial
dynamic
prior
creases
in
whets
onset
Seventeen
diately
of
or during
count
patient.
of Brucella
Phagocytosis
therapy
neutrophil
The
phagocytosis
impaired.
del
factores
neutroes etiam
patientes
con
len-
acute.
REFERENCES
1
HIRSCHBERG,
2
BRAUDE,
N.: Phagocytic
A., FELTES,
J., ANt)
granulocytes
types
in leukemic
M.
STRUMIA,
of
AND
leukemias.
activity
BRooKs,
and
normal
in leukemia,
Am. J. M. Sc. 197: 706, 1939.
M.: Differences
between
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of mature
blood.
J. Clin.
F.: Phagocytic
activity
Am. J. Pathol.
13: 335, 1937.
BOERNER,
Invest.
33:
of circulating
1036,
cells
1954.
in the
various
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213:
H.,
SOUTHAM,
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in leukemia
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SCHNEII)ER\IAN
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NI)
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of
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6
BEAL,
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hERMAN,
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ANt)
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the
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natural
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occurrence
of remissions.
with special
reference
to the duration
of the disease
and the
Cancer
4: 39, 1951.
DIAMOND,
L. AND LUHBY,
A.: Pattern
of “spomstaneous”
remissiots
in leukemia
of childhood observed
in 26 of 300 cases. (Abstract)
Am. J. Med. 10: 238, 1951.
8 BASSEN,
F. AND KOHN,
J.: Mutltiple
spontaneous
remissions
in a child with acute leukemia.
Blood
7: 37, 1952.
SILVER,
R. UTZ, J., FREI,
li., ZUBROD,
C., AND
MCCULLOUGH,
N.: Infections,
fever,
and
host resistance
in acute
leukemia.
Proceedings,
VI
International
Hematology
Congress,
1956. In press.
‘#{176}
Clinical
Studies
Panel,
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Chemotherapy
National
Service
Cetster,
Criteria
for the
evaluation
of response
to treatment
in acitte
leukemia.
(Letter
to the
editor)
Blood
9: 676, 1956.
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I.,
HUDDLESON,
12 JERSILD,
Infect.
M.:
Dis.
Brucellosis
its man
A cytophagic
68:
N.
16,
reaction
and
animals.
employed
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York,
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Fund,
of
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bruscella
1943.
J.
1941.
L.: A staitsing
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Technology
17: 153,
1942.
“BEST,
W., LIMARZI,
L., AND PONCER,
H.: White
blood
stract)
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Computation
Laboratory,
Harvard
Ursiversity,
Tables
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Comniotswealth
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AND
DIcK,
for
use
its
the
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opsono-
Stain
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1955
leucemias.
(Ab-
binomial
prols-
From www.bloodjournal.org by guest on June 18, 2017. For personal use only.
1957 12: 814-821
The Role of the Mature Neutrophil in Bacterial Infections in Acute Leukemia
RICHARD T. SILVER, GRACE A. BEAL, MARVIN A. SCHNEIDERMAN and NORMAN B.
MCCULLOUGH
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