Immunological characterization of non-Hodgkin's lymphoma: enrichment of neoplastic cells from lymphoid tissues and blood

Monoclonal B-cells in blood in non-Hodgkin lymphoma. Correlation with clinical features and prognoses

Presence of monoclonal B-cells in peripheral blood (MBCB) was studied in 132 previously untreated patients with non-Hodgkin lymphoma classified according to the Kiel classification. Detection of B-cells was performed by immunofluorescence microscopy, using antibodies against immunoglobulin light chains. Thirty-six patients (27%) were found to have MBCB. In the subgroup of low grade lymphomas 25/75 (33%) and in high grade lymphomas, 11/57 (19%) had MBCB. Presence of MBCB was correlated to clinical stage and 81% of the patients with MBCB were in stage IV. Twenty-two out of 36 (61%) patients with MBCB had normal lymphocyte counts (less than 5.0 X 10(9]. MBCB indicated a less favourable prognosis, mainly due to the close association with stage IV. It was concluded that studies of MBCB by this simple method are useful in detecting 'subclinical' blood involvement and valuable in the initial staging procedure as well as in the follow-up of the patients.

Surface immunoglobulin restriction in B-non Hodgkin's lymphomas in cell suspension and on frozen tissue sections

The diagnostic relevance of different tests for detection of surface immunoglobulin on tumour cells of B-type non-Hodgkin's lymphomas (B-NHL) was investigated by comparison of the direct antiglobulin rosetting reaction (DARR) in suspension with two-colour direct immunofluorescence (DIF) on frozen tissue sections. In benign lymph nodes (n = 27) the kappa/lambda ratio by DARR test ranged from 0.9 to 2.8. Tested by suspension and frozen tissue analysis, light chain restriction was found in 24 and 27 of 31 cases of B-NHL, respectively. Heavy chain restriction was found in half of the cases (14 of 26) studied in suspension and in almost all (28 of 31) tested on sections. In 9 cases DARR tests showed restriction of more than one Ig class on tumour cells, which was infrequent (2 of 28) in frozen section analysis. Although both tests appeared valuable for routine diagnostic purposes, we found the DIF analysis on tissue sections somewhat more discriminative, especially in detection of heavy chain restriction in B-NHL.

Monoclonal B cells in peripheral blood in non-Hodgkin's lymphoma. Correlation with clinical features and DNA content

Peripheral blood from 69 patients with non-Hodgkin's lymphoma was examined with respect to B and T cell markers. Evidence for monoclonal B cell was found in 29 cases, 8 of 'high grade' and 21 of 'low grade' malignancy according to the Kiel classification. 17 out of the 29 patients had a normal lymphocyte count. Using conventional staging methods 4 cases of the 29 were in stages II and III, all others in stage IV. The proportion of S-phase cells in peripheral blood, determined by flow cytometry, was found to be elevated in cases with a monoclonal cell population. It is concluded that surface marker analysis of blood cells may be valuable as a diagnostic tool, as an indicator of prognosis and perhaps for the staging procedure of malignant lymphomas.