Chronic Lymphocytic Leukemia, Hypogammaglobulinemia and Autoimmune Hemolytic Anemia— An Experiment of Nature

1. The case study is presented of a 75 year old man who had chronic lymphatic leukemia, autoimmune hemolytic anemia and hypogammaglobulinemia. The positive antiglobulin reaction with serum made from gamma globulin and the neutralization of the antiglobulin reaction with human gamma globulin demonstrated that this patient’s erythrocytes were coated with gamma globulin.

2. There was a normal survival time of I¹³¹-labeled normal human gamma globulin, suggesting defective synthesis of gamma globulin. Failure to demonstrate radioactivity on the patient’s erythrocytes when I¹³¹-labeled normal gamma globulin was given signified that normal human gamma globulin has no affinity in vivo for the patient’s red cells and that the erythrocyte-coating protein was derived from a source endogenous to the patient.

3. These relationships favor an immunologic mechanism in the development of an antiglobulin reaction in this patient.