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High incidence of monoclonal proteins in the serum and urine of chronic
lymphocytic leukemia patients
MJ Deegan, JP Abraham, M Sawdyk and EJ Van Slyck
Chronic lymphocytic leukemia (CLL) is generally considered a nonsecretory B
cell immunoproliferative disorder. Conventional electrophoretic and
immunoelectrophoretic methods have revealed serum monoclonal proteins in
less than 10% of these patients. However, there is increasing experimental
evidence from in vitro studies demonstrating that CLL cells may secrete
immunoglobulins, particularly free light chains. We examined the serum and
urine of 36 consecutive CLL patients for monoclonal proteins using
sensitive immunochemical methods (high resolution agarose gel
electrophoresis combined with immunofixation). The results obtained were
correlated with the Rai stage, quantitative immunoglobulin levels, and
lymphocyte membrane immunoglobulin phenotype of the leukemic cells.
Twenty-three monoclonal proteins were identified in the serum or urine of
22 patients, an incidence of 61%. Six patients had serum monoclonal
proteins, seven had only urinary monoclonal proteins, and nine had
monoclonal proteins in serum and urine. In every instance the monoclonal
protein was the same light chain type as expressed on the leukemic cells.
Our findings suggest that the monoclonal proteins observed in the serum or
urine of CLL patients are secretory products of the tumor cells and that
their discovery is a function of the sensitivity of the method used for
their detection.
Volume 64,
Issue 6,
pp. 1207-1211,
12/01/1984
Copyright © 1984 by The American Society of Hematology
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