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The T lymphocytes populations of 22 young healthy adults, 21 healthy middle aged and older blood donors, 35 non-pregnant women of child bearing age and 14 patients with advanced malignant disease were assessed and compared. It was found that the mean T cell counts in the middle aged and older controls were significantly lower than in the healthy young adults and were further reduced in the patients with malignant disease. The addition of the proteolytic agent brinase (protease 1 obtained from Aspergillus oryzae) to the rosetting test increased the T cell counts signficantly in all groups. This was mot marked in the older age groups and the patients with malignant disease. The proteolytic agent is shown to exert its effect on the lymphocytes in the test. Slow intravenous infusion of either brinase or streptokinase into patients with malignant disease is shown to result in increased T lymphocyte counts pari passu with a restoration of skin allergy. The significance of these findings and possible mode of action of the proteolytic agents in increasing T cell activity are discussed.

Following a course of therapy with protease 1. four cases of acute leukaemia were shown to have complement dependent cytotoxic autoantibodies against their own leucocytes and leukaemic cells. Their presence was suspected clinically in a further case. Whole blood transfusion resulted in severe depression of total white cell counts and platelets in three cases. Another case went into remission after a whole blood transfusion. An adult case of acute myeloblastic leukaemia responded well to protease 1 and developed autoantibodies in the fourth week of therapy, but was not affected by packed cell transfusion. It is suggested that these, cases were deficient in complement.

1 Two thousand, one hundred and seventy-three patients with cancer or chronic infections were treated with coumarin in a clinical trial. 2 0.37% of these patients developed elevated liver enzyme levels during therapy with coumarin. 3 This hepatitis was probably a form of idiosyncratic hepatotoxicity and may have been immune in origin.