Morphological changes in leukemic lymphoblasts and normal lymphocytes treated with deoxyadenosine plus deoxycoformycin

It remains unclear how lympholysis occurs in children with an inherited deficiency of adenosine deaminase (ADA) and in leukemic patients undergoing treatment with an inhibitor of ADA, deoxycoformycin. Adenosine deaminase deficiency with subsequent lympholysis can be simulated in vitro by treatment of lymphoid cells with deoxyadenosine plus deoxycoformycin. We found that such in vitro treatment caused fragmentation of the nucleus, disintegration of nuclear chromatin, and the formation of cytoplasmic blebs in T-lymphoblast lines, but not in B-lymphoblast lines. For all but one of the cell lines tested, the extent of morphological changes paralleled the sensitivity to growth inhibition by deoxyadenosine plus deoxycoformycin. Similar morphological changes were observed in normal peripheral blood lymphocytes treated with deoxyadenosine plus deoxycoformycin. These morphological changes were energy-dependent processes. They were preceded by inhibition of DNA synthesis and deoxyadenosine triphosphate (dATP) accumulation, but followed by depletion of adenosine triphosphate (ATP) and cell lysis. These changes may represent an intermediate step between metabolic alterations and lympholysis.