Journal of Postgraduate Medicine
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Year : 1980  |  Volume : 26  |  Issue : 1  |  Page : 86-9  

Levels of the IgG immunoglobulin and Immunoglobulin marker Gm(1) in leukaemias.

SH Joshi, YS Iyer, SN Naik, HM Bhatia 
 

Correspondence Address:
S H Joshi





How to cite this article:
Joshi S H, Iyer Y S, Naik S N, Bhatia H M. Levels of the IgG immunoglobulin and Immunoglobulin marker Gm(1) in leukaemias. J Postgrad Med 1980;26:86-9


How to cite this URL:
Joshi S H, Iyer Y S, Naik S N, Bhatia H M. Levels of the IgG immunoglobulin and Immunoglobulin marker Gm(1) in leukaemias. J Postgrad Med [serial online] 1980 [cited 2022 Jan 26 ];26:86-9
Available from: https://www.jpgmonline.com/text.asp?1980/26/1/86/995


Full Text



 INTRODUCTION



Varying degree of immunologic defects and haemolytic anemias is a common feature in all varieties of leukaemias. The immunologic defect could be either cell mediated or humoral; the latter type is also reflected in the alteration in immunoglobulin levels. There is no definite pattern of the particular immunoglobulin type being affected in different leukaemic conditions.[6] Since Gm factor is an antigenic marker of the IgG, the variation in the IgG immunoglobulin may also affect the quantitative levels of Gm factor. Present study was therefore undertaken to study the Gm(1) factor and correlate the levels of Gm(1) with the IgG levels in leukaemias.

 MATERIAL AND METHODS



Seventy-four cases of leukaemias were referred from Tata memorial hospital. These included 52 cases of CAM, 7 cases of AML, 6 cases of CLL and 9 cases of ALL. The serum was separated and stored at 20C, till use. Determination of Gm(1) factor was done using local antiGm(1) and anti-Rh Coat.[3] Quantitative Gm (1) levels were determined by haemagglutination inhibition titre of the test sample. Quantitative levels of IgG were determined by passive haemagglutination inhibition test using locally prepared anti-IgG and ORh positive red cells coated with incomplete anti-Rh.5 The normal samples for comparative levels were obtained from voluntary donors attending the KEM Blood Bank.

 RESULTS



[Table 1] gives the findings of Gm (1) levels and IgG levels in the cases of leukaemias. Thirteen out of 74 leukaemic patients (17.617c) gave inhibition titre of less than 1:4 indicating as Gm(1) negative. While the levels of Gm(1) content in 45 Gm(1) positive normal individuals were upto 1:64, 31 out of 61 (42) Gm (1) positive leukaemic patients had increased Gm(1) levels. Fourteen of them had very high levels. The IgG levels in leukaemic patients showed 9 (12%) of them with hypogammaglobulinemia while 13 (17.3%) of them showed hyper IgG.

[Table 2] gives the findings of Gm(1) and IgG levels on the basis of myeloid and lymphoid leukaemia as well as acute and chronic state of the disease. The findings showed no significant differences of the Gm (1) as well as IgG levels on the basis of myeloid or lymphoid type of leukaemias. None of the 16 acute leukaemias showed very high levels of Gm(1) while 14 out of 58 chronic leukaemias had very high levels of Gm (1). However this distribution pattern was not statistically significant. The IaG levels were found to be low in 9 out of 58, chronic leukaemias and in none out of 16 acute leukaemias. Again the distribution pattern was not statistically significant.

[Table 3] gives the comparison between the high Gm(1) levels with high IgG levels in leukaemia patients. Finings do not suggest correlation between Gm (1) and IgG levels. Interestingly 6 out of 28 patients with increased Gm(1) levels showed hypogammaglobulinemia.

Analysis of data did not show any significant correlation for the increased IgG as well as Gm (1) with the age or sex of patients.

 DISCUSSION



Leukaemia patients of all types exhibit a varying degree of anaemia and immunologic defect. Immunoglobulin though not grossly affected may show generalised deficiencies in acute phase.[6] On the other hand, increased immunoglobulin, sometimes even myeloma type has also been reported in chronic lymphatic leukaemias., Thus there is no specific pattern related to the type and severity of the disease though immunoglobulins tend to be low in the late course of acute leukaemia.[6] The present study of the IgG levels also does not reflect a specific pattern with nearly 12% of them having reduced levels and 17% having increased levels. These altered levels are neither related to myeloid or lymphoid series nor associated with acute or chronic nature of the disease. None of the 13 cases with increased IgG showed myeloma protein as reported by Azar et al.[1] This is interpreted as an intermediate form between lymphoproliferative disorder and the plasmocytoma. It is likely that, reduced levels of IgG immunoglobulin in some of the patients may be due to the early effect of chemotherapy.} This may help in monitering the chemotherapy in patients with increased IgG levels. Borella et al[2] also observed an increase in serum immunoglobulin and antibody production on withdrawl of chemotherapy specially in younger than in older children.

Because of the changes in IgG immunoglobulin in leukaemias, the changes in the levels of Gm(1) factor, which is an antigenic marker of IgG is not surprising. Nearly 40% showed increased levels. Significantly higher increase in Gm(1) content is more a characteristic in chronic leukaemias of both myeloid as well as lymphoid types. Present study also showed that there was no direct correlation between the IgG and Gm(1) levels. While only four out of eleven patients with increased IgG had high Gm (1) content, six out of the sixteen patients with decreased IgG also showed an increase in the Gm (1) content though the increase in all these six cases was only marginal. However these findings may indicate that different IgG sub-classes are affected in leukaemia rather than generalised increase or decrease in all subclasses.

References

1Azar, M. A., Hill, W. T. and Osserman, E. F.: Malignant lymphoma and lymphatic leukaemia associated with myeloma type serum proteins. Amer. J. Med., 23: 239-249, 1957.
2Borella, L., Green, A. A. and Webster, R. G.: Immunologic rebound after cessation of long-term chemotherapy in acute leukaemia. Blood, 40: 42-51, 1972.
3Joshi, S. H. and Bhatia, H. M.: Serum groups Gm(1) and Gm(2) in Indians. Ind. J. Med. Res., 62: 1459-1461, 1974.
4Kiran, O. and Gross, S.: The G-immunoglobulins in acute leukaemia in children. Hematologic and immunologic relationships. Blood, 33: 198-2'06, 1969.
5Srinivasan, K. and Bhatia, H. M.: Studies on immunoglobulin specificity of Rh antibodies. Ind. J. Med. Res. 61: 7177, 1973.
6Thompson, R. B.: "Disorders of Blood." Churchill Livingstone. London, 1977, p. 604.

 
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