Cell surface expression of beta 2-microglobulin (beta 2m) correlates with stages of differentiation in B cell tumours

Outcomes and second neoplasms in hairy cell leukemia: A retrospective cohort

Hairy cell leukemia (HCL) is a rare chronic B-cell lymphoproliferative disease which is treated on the basis of small studies, making the literature still scarce of reports, especially of those conducted in Latin America. Here we intend to describe clinical characteristics, rates of response, survival and second neoplasms in HCL patients treated in a reference center in Brazil. All patients diagnosed with HCL between July/1987 and Jun/2018 were included in this analysis. Fifty-four patients were included in this analysis. Median age at diagnosis was 55 years (range, 26-88), with 37% being above 60 years-old. Most patients were treated with cladribine in our cohort (n = 36; 68%), administered through intravenous continuous infusion. Remaining patients were firstly managed with splenectomy (n = 7; 13%), IFN (n = 6; 11%) and rituximab (n = 2; 4%). In a univariate analysis, platelet count and B2M level at diagnosis were statistically associated with CR achievement (p = 0.004 and p = 0.024, respectively). A median follow-up time of 9 years was calculated. Estimated 10-year overall survival was 91.1% (95% confidence interval, 77-97). In this cohort, 10 patients had any second neoplasm, diagnosed before or after HCL. Regarding the sites of cancer, 69% were of skin - 8/16 carcinoma-type and 3/16 melanoma-type. Our response and survival data are similar to those reported by literature, which reaffirms the role of purine analogs in current HCL management. With a very long follow-up we also have observed a high incidence of second neoplasm.

A comparative analysis of neuroblastic and substrate-adherent human neuroblastoma cell lines

In human neuroblastoma cell cultures, two phenotypes with differing biological properties have been described: neuroblastic (N) and substrate-adherent (Schwannian or S). In nude mice, N cells are rapidly growing, clonigenic in soft agar, and tumorigenic, whereas S cells are not. The difference in malignant properties between these two cell types and their ability to interconvert in vitro may have clinical relevance. In an attempt to identify genes that may be important in the phenotypic differences and the interconversion, the authors analyzed five representative N and three S cell lines for differential expression of six genes relevant to uncontrolled growth. Beta2-microglobulin was the only gene measured that showed differential expression between the N and S cell lines. This finding supports the theory that beta2-microglobulin and class I MHC expression are markers for differentiation as well as the use of beta2-microglobulin as a differentiation marker in neuroblastoma. The data also suggest that a disregulation of the beta2-microglobulin gene may be partly responsible for the tumorigenicity of the N phenotype.

Cell surface markers in multiple myeloma

OBJECTIVE

To describe the immunophenotype of normal and myelomatous plasma cells (PCs) and the changes in immunoregulatory nonmyelomatous cells in multiple myeloma (MM).

DESIGN

The cell surface markers (antigens) associated with this common cancer were reviewed.

MATERIAL AND METHODS

Immunophenotypic characterization of both normal PCs and their counterpart malignant hematopoietic cells can be achieved by using monoclonal antibodies and either flow cytometry or immunocytochemical techniques.

RESULTS

Normal PCs are heterogeneous and express, in addition to cytoplasmic immunoglobulins, the antigens CD9, CD10, CD13, CD19, CD20, CD33, CD38, and D-related human leukocyte antigen (HLA-DR). This heterogeneity also occurs in malignant PCs. Myelomatous PCs may express, in addition to CD38 (the most typical PC marker), the antigens CD9, CD10, HLA-DR, and CD20. Other non-B-cell lineage markers such as myeloid (CD13, CD14, CD15, CD33, CD41, and glycophorin A), T-cell (CD2 and CD4), and natural killer-associated (CD56) antigens, as well as CD23, CD24, CD25, CD37, CD39, CDw40, CD45R, CD71, and certain unclustered antigens (R1-3, PCA-1, PCA-2, PC1, 62B1, 8A, 8F6, and MM4), have been noted in myelomatous PCs. The presence of these antigens in the myeloma cells may have a prognostic value--for example, the expression of CD20 and of myelomonocytic antigens (CD11b, CD13, CD14, CD15, and CD33) may be related to a poor prognosis. The adverse prognostic implication of the expression of CD10 initially described in MM has not been subsequently confirmed. Patients with MM may have mononuclear cells in their peripheral blood that express the same antigens as those expressed by the myeloma cells in their bone marrow. The presence of such cells or their therapy-associated decrease or disappearance may be related to the prognosis of patients with MM.

CONCLUSION

The presence of cell surface markers on PCs and their prognostic significance in patients with MM warrant further investigation.

Relationship between CD45 antigen expression and putative stages of differentiation in B-cell malignancies

The cell-surface antigen CD45 is a complex family of high-molecular-weight glycoproteins expressed on all lymphohematopoietic cells, but not in the same molecular isoform. This antigen complex is known to exhibit protein tyrosine phosphatase (PTPase) activity and appears to have a role in regulation of cell differentiation. In that CD45 expression parallels stages of differentiation in normal bone marrow B cells, it was of interest to evaluate this process in malignant B cells. Monoclonal antibodies (MoAbs) were used to investigate the quantitative expression of CD45 and CD45RA on the B cells of lymphoid leukemias. Employing standardized flow cytometric methods, it was found that the fluorescence intensity (FI) of immunostained malignant B cells, as a reflection of the antigen content, demonstrated correlations with the putative stage of cell differentiation for malignancies at the earlier stages, but at the later stages, a progressive loss of CD45 was observed. Since this antigen family has been found to display PTPase activity, further investigation of CD45 alterations in malignancies may provide insight into potential regulatory disturbances.

Phenotypic switch from CD45RA+ to CD45RA- by normal blood T cells is associated with increased HLA-ABC expression for CD4+ and CD8+ populations but not for the NK-associated CD4-CD8dim+ or CD4-CD8- fractions

Using the combined techniques of immunomagnetic depletion and multiple colour flow cytometry, the expression of HLA-ABC (W6/32) by normal T-cell subpopulations, defined by 2H4 (CD45RA) expression, was examined. It is thought that a CD45RA+CD45RO- phenotype defines the 'virgin' T-cell fraction, whereas a CD45RA-CD45RO+ phenotype defines the 'primed' or memory T-cell population. In addition, an intermediate phenotype (CD45RA+CD45RO+) appears to correspond to a transitional stage of development. In this study, these three phenotypic stages were represented by distinct levels of 2H4 staining defined as 2H4+, 2H4int and 2H4-, respectively. The results of this current investigation are of importance in two main areas. Firstly, when compared to the 2H4+ component, the HLA-ABC expression of 2H4- cells was significantly higher. This was true for both CD4+CD8- and CD4-CD8+ lymphocytes, but was not the case for CD4-CD8dim+, CD3+CD4-CD8- and CD3-CD4-CD8- fractions. Additionally, when HLA-ABC expression was examined as a function of 2H4 staining intensity, it was found that, for the CD4+ fraction, the greatest increase in HLA-ABC expression occurred between the 2H4int and 2H4- stages. In contrast, the increase in HLA-ABC expression by CD8+ lymphocytes was associated with transition from 2H4+ to 2H4int status, which suggests that increased HLA-ABC expression occurs at an earlier stage in the acquisition of CD45RO in CD8+ cells than for CD4+ cells. Secondly, for each individual blood examined, a close and highly significant correlation (P = 0.002) for membrane HLA-ABC expression was found between (i) CD4+2H4+ and CD8+2H4+ and (ii) CD4+2H4- and CD8+2H4- subpopulations. This suggests that modulation of HLA-ABC expression in CD4+ and CD8+ cells is subject to common control mechanisms and remains proportionate for these lymphocyte fractions in any given individual.

Fluctuations of plasma beta 2-microglobulin, soluble interleukin 2 receptor and interferon-gamma concentrations after adoptive immunotherapy with high-dose interleukin 2 and lymphokine-activated killer cells

We report the serum levels of soluble interleukin 2 receptor (sIL2R), beta 2-microglobulin (beta 2-M) and interferon-gamma (IFN-gamma) in patients undergoing adoptive immunotherapy with rIL2 and lymphocyte-activated killer (LAK) cells. Our results indicate that rIL2 induced a marked increase of the serum concentration of these markers, although this increase varied considerably for different individuals. Parallel studies with the same patients also showed a marked rise in the number of IL2R+ lymphocytes: the IL2Rs expressed on these cells were mainly of the "low affinity" type. We suggest that evaluation of these markers may allow the monitoring of immune system activation induced by rIL2 in patients undergoing adoptive rIL2 and LAK cell immunotherapy.

Diagnostic differentiation of chronic B-cell malignancies using monoclonal antibody L161 (CD1c)

The expression of membrane CD1c, as defined by monoclonal antibody L161, was examined on malignant lymphoid cells from 191 cases of chronic lymphoproliferative disease and on eight 'normal' enriched tonsil B-cell extracts. Of 79 cases of chronic lymphocytic leukaemia (CLL) studied, 77 showed low (less than 20% positive cells) CD1c expression whereas 63/71 (89%) cases of B-PLL, HCL and B-NHL showed increased CD1c+ (but not CD1a or CD1b) components. In contrast, malignancies corresponding to terminal stages of B-cell differentiation (immunocytoma and myeloma) generally showed low CD1c expression as did lymphoid cells from 10 cases of post-thymic malignancy. Although there was some correlation between the expression of membrane CD1c and immunoglobulin (SIg) light chain densities (P less than 0.001), it is relevant in diagnostic terms that seven cases of B-NHL with low SIg staining intensities more typically associated with CLL were CD1c+. CD1c expression was not, however, correlated with the presence of CD23 or FMC7 determinants but did show a similar pattern of expression to that previously reported for beta-2 microglobulin. Determination of cellular CD1c by APAAP immunocytochemistry confirmed the presence of higher antigen densities in malignant B-cells at intermediate/late stages of differentiation and this interpretation was further supported by the finding that the majority of phenotypically mature tonsil B-cells were also CD1c+. The determination of CD1c expression by malignant B-cells may therefore be of particular value in the diagnostic differentiation of chronic lymphoproliferative disorders.