Effect of chemotherapy on T-lymphocyte subsets in B-cell proliferative disorders

The T-cell subset distribution and the activity markers of 41 patients with multiple Myeloma, Waldenström's macroglobulinaemia and benign monoclonal gammopathy were repeatedly analysed using monoclonal antibodies (T3, T4, T8, anti-TAC, anti DR) and rosetting techniques. In myeloma and macroglobulinaemia the relative and absolute numbers of T4+ cells were diminished while the absolute number of T8+ cells was not decreased. No significant difference between stage I and III of the myeloma disease was seen. The diminished number of T4+ cells in myeloma was partly due to the effect of chemotherapy. Chemotherapy-induced lymphopenia resulted in a drop of circulating T4+ cells and an inverted T4/T8 cell ratio. Untreated patients with myeloma were not significantly different from patients with benign gammopathy. Patients with macroglobulinaemia differed from patients with myeloma as they had an increased absolute T8 cell count and a significantly elevated percentage of TAC+ (= IL 2 receptor expressing) cells. In macroglobulinaemia chemotherapy affected also the T8+ cell subset. Thus, patients with macroglobulinaemia, but not with myeloma appear to have activated T8+ cells in their circulation.