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Origin of the Hodgkin/Reed-Sternberg Cells in Chronic Lymphocytic
Leukemia With "Hodgkin's Transformation"
Toshiyuki Ohno,
Bassam N. Smir,
Dennis D. Weisenburger,
Randy D. Gascoyne,
Steven D. Hinrichs, and
Wing C. Chan
From the Department of Pathology and Microbiology, University of
Nebraska Medical Center, Omaha; the Department of Pathology, University
of Texas Health Science Center at San Antonio, San Antonio; and the
Cancer Control Agency of British Columbia, Vancouver, British Columbia,
Canada.
A lymphoma with the characteristic features of Hodgkin's disease
(HD) occasionally develops in patients with B-cell chronic lymphocytic
leukemia (CLL), and has been called Richter's syndrome with HD
features. In such cases, large tumor cells have the morphological and
immunophenotypic features of classical Hodgkin and Reed-Sternberg (H-RS) cells. However, it is not known whether the H-RS cells arise
from transformation of the underlying CLL cells or from a different
pathological process. We report herein a study of the clonal
relationship between the CLL cells and the H-RS cells in three cases of
Richter's syndrome with HD features by using a single cell assay. We
isolated single CLL cells and H-RS cells from immunostained tissue
sections by micromanipulation. The immunoglobulin heavy chain gene
(IgH) complementarity determining region (CDR) III of each cell was
amplified by the polymerase chain reaction (PCR). The products were
then compared by gel electrophoresis and nucleotide sequencing. The IgH
CDRIII sequences from the H-RS cells were identical to those from the
CLL cells in two cases. In one case, the clonal relationship between
the two types of cells could not be determined because PCR products
could not be obtained from any of the H-RS cells. This study shows that
the H-RS cells and the CLL cells belong to the same clonal population in some cases of Richter's syndrome with HD features. Furthermore, our
findings indicate that mature B cells can undergo transformation to
cells with the features of H-RS cells, in association with a cellular
background typical of HD. This study also supports recent findings
suggesting that the H-RS cells in classical HD are derived from
transformed B cells.
Blood, Vol. 91 No. 5 (March 1), 1998:
pp. 1757-1761
© 1998 by The American Society of Hematology.
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