Heterogeneity of “Acquired” or Common Variable Agammaglobulinemia

Abstract

Abstract Circulating T (thymus-derived) and B (bone-marrow-derived) lymphocytes were assessed in 19 patients with common variable or acquired agamma-globulinemia. T-cell number and function were concomitantly depressed in five of these patients who had other debilitating illnesses. B-cell number was normal in 10 patients, increased in five, and markedly reduced in four. Transformation of B cells into immunoglobulin (Ig) secretory cells in the presence of a soluble T-cell-derived lymphocyte mitogenic factor (LMF) was studied in the 15 patients with B cells. B cells from nine of these patients, when stimulated with LMF, failed to synthesize Ig. In five other patients, B cells divided and made Ig, but they failed to secrete it. A single patient had a factor in his serum that inhibited activation of both normal and autologous B cells by LMF. Acquired or common variable agammaglobulinemia is a heterogeneous disease caused by defects occurring at various steps in the maturation pathway of the B cell into an...