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BR Smith, NJ Robert and KA Ault
Using a sensitive flow-cytometer-based method of detecting small numbers of
morphologically normal monoclonal B lymphocytes, we have investigated the
presence and quantity of these cells in the blood of 12 patients with
Waldenstrom's macroglobulinemia. All 12 patients, including 6 at the time
of asymptomatic presentation, had such circulating monoclonal cells. By
comparison, 2 of 7 patients with multiple myeloma had such cells, and prior
studies have shown that 80% of patients with non-Hodgkin's lymphoma exhibit
blood involvement by these criteria. Enzymatic removal of surface
immunoglobulin (lg) with subsequent regeneration by the cells after
overnight culture established that the monoclonal surface lg being studied
was of intrinsic cell membrane origin and not passively adsorbed serum lg.
Serial studies were performed in 7 patients. In the 4 cases where a
clinical response to therapy and a decrease in serum IgM level was seen,
there was a corresponding decrease in the estimated number of abnormal
cells. In the 3 cases where there was neither clinical nor serum
M-component evidence of response, the estimated percent abnormal cells
likewise increased or remained constant. We conclude that patients with
Waldenstrom's macroglobulinemia have a significant number of peripheral
blood monoclonal B lymphocytes, even early in their disease, and that for a
given patient, serial determinations of the number of these cells as
estimated by flow cytometry reflects the clinical activity of the disease.
This article has been cited by other articles:
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| Copyright © 1983 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||
