In 8 of 12 patients (66.6%), B-CLL cells in vitro constitutively produced TNFα and exerted a TNFα-mediated cytotoxicity, evaluated in an 18-h 51Cr release assay, against the TNFα-sensitive Jurkat, U937 and K562 cell lines but not against the TNFα-resistant Raji cell line. Involvement of TNFα in B-CLL cell cytotoxicity is demonstrated by the fact that anti-TNFα antibodies strongly inhibited it and supernatants of cytotoxic cultures contained TNFα and mediated a completely TNFα-dependent cytotoxicity. When the cytotoxic B-CLL cells were stimulated with interleukin (IL)-2 plus IL-12, there was increased TNFα mRNA expression, TNFα production and TNFα-mediated cytotoxicity. All eight patients with cytotoxic leukemic cells had progressive disease and six of these also expressed high levels of ZAP-70 protein. In the other four patients (33.3%), B-CLL cells did not produce TNFα in vitro and were not cytotoxic, either spontaneously or after IL-2 plus IL-12 stimulation. Of these four patients, three had stable disease and one had progressive disease. The patient with progressive disease and one of the three with stable disease expressed low levels of ZAP-70 protein. We conclude that a group of B-CLL patients with progressive disease have leukemic B cells able to exert in vitro a TNFα-mediated cytotoxicity, which is modulated by cytokines.
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