Detection of two distinct malignant B cell clones in a single patient using
anti-idiotype monoclonal antibodies and immunoglobulin gene rearrangement
SL Giardina, RW Schroff, CS Woodhouse, DW Golde, RK Oldham, ML Cleary, J Sklar, N Pritikin and KA Foon
Immunoglobulin gene rearrangement analysis and somatic cell hybridization
techniques were used to examine the malignant cell population in an unusual
patient with hairy cell leukemia and macroglobulinemia (N Engl J Med
296:92, 1977). Although previous investigations suggested that the IgM
macroglobulin was secreted by the circulating leukemia cells, anti-idiotype
monoclonal antibodies raised to the IgM macroglobulin failed to react with
the malignant cells in the circulation and bone marrow. In contrast,
approximately 50% of the mononuclear cells from an enlarged inguinal lymph
node reacted strongly with the anti-idiotype antibodies. Subsequent
reanalysis of all cell populations demonstrated that whereas the
circulating and bone marrow cells were IgM kappa-bearing, the macroglobulin
was IgM gamma-bearing and the lymph node cells were evenly divided among
IgM kappa-bearing and IgM gamma-bearing. Immunofluorescence flow cytometry
indicated that those lymph node cells that reacted strictly with the
anti-idiotype antibody were IgM gamma-bearing, demonstrating that they were
the source of macroglobulin. An analysis of immunoglobulin gene DNA
confirmed the coexistence of two distinct malignant B cell populations in
the lymph node and indicated that the IgM kappa-bearing lymph node cells
were identical to the circulating and bone marrow leukemic cells.
Volume 66,
Issue 5,
pp. 1017-1021,
11/01/1985
Copyright © 1985 by The American Society of Hematology
