The significance of B-clonal excess in peripheral blood in patients with non-Hodgkin’s lymphoma in remission

  • Anna Johnson
  • Eva Cavallin-Ståhl
  • Måns Åkerman

Summary

By taking advantage of the monoclonal nature of non-Hodgkin’s lymphoma (NHL) it has been possible to detect small numbers of lymphoma cells which are not evident by routine morphological methods. These new methods are based on the detection of either a restricted light chain expression — clonal excess analysis (CE) or a monoclonal rearrangement of the Ig or T-cell receptor genes. We have studied the impact on relapse and survival of CE in peripheral blood in 202 patients in remission. The patients were sampled repeatedly during follow-up in remission. Median follow-up was 55 months (range 1–180). CE was found more frequently during remission in patients with low-grade NHL 18% as compared to 8% in high-grade NHL. There was no correlation with initial stage and the occurrence of CE in remission. Survival and time to relapse did not differ in those with CE and those with a normal light chain distribution. The conclusion is that CE in remission does not herald a poor prognosis and that an isolated finding of CE in remission is not an indication to start therapy.

Keywords

Albumin Lymphoma DMSO Leukemia Electrophoresis 

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References

  1. 1.
    Ault K.: Detection of small numbers of monoclonal B lymphocytes in the blood of patients with lymphoma. N Engl J Med 1979; 300: 1401–5.PubMedCrossRefGoogle Scholar
  2. 2.
    Ligler F, Vitetta E, Smith G et al.: An immunological approach for the detection of tumor cells in the peripheral blood of patients with malignant lymphoma; implications for the diagnosis of minimal disease. J Immunol 1979; 123: 1123–6.PubMedGoogle Scholar
  3. 3.
    Ligler F, Smith G, Kettman J et al.: Detection of tumor cells in the peripheral blood of nonleukemic patients with B-cell lymphoma: Analysis of `Clonal excess.’ Blood 1980; 55: 792–800.Google Scholar
  4. 4.
    Smith B, Weinberg S, Robert N et al.: Circulating monoclonal B lymphocytes in non-Hodgkin’s lymphoma. N Engl J Med 1984; 311: 1476–81.PubMedCrossRefGoogle Scholar
  5. 5.
    Sobol R, Dillman R, Collins H et al.: Applications and limitations of peripheral blood lymphocyte immunoglobulin light chain analysis in the evaluation of non-Hodgkin’s lymphoma. Cancer 1985; 56: 2005–10.PubMedCrossRefGoogle Scholar
  6. 6.
    Nakano M, Kuge S, Kuwabara S et al.: The basic study on x-a. imaging by ó-curve for the detection of a monoclonal B-cell population in the peripheral blood. Blood 1988; 72: 1461–6.PubMedGoogle Scholar
  7. 7.
    Johnson A, Cavallin-Stâhl E, Akerman M.: Flow cytometric light chain analysis of peripheral blood lymphocytes in patients with non-Hodgkin’s lymphoma. Br J Cancer 1985; 52: 159–65.PubMedCrossRefGoogle Scholar
  8. 8.
    Ostberg-Landaas T, Godal T, Marton P et al.: Cell-associated immunoglobulins in human non-Hodgkin’s lymphoma. A parative study of surface immunoglobulins on cells in suspen- sions and cytoplasmatic immunoglobulin by immunohisto- chemistry. Acta path microbiol scand Sect A 1981; 89: 91–101.Google Scholar
  9. 9.
    Cleary M, Chao J, Warnke R et al.: Immunoglobulin gene rearrangement as a diagnostic criterion of B-cell lymphoma. Proc Natl Acad Sci USA 1984; 81: 593–7.PubMedCrossRefGoogle Scholar
  10. 10.
    Cleary M, Trela M, Weiss L et al.: Most null large cell lymphomas are B lineage neoplasms. Lab Invest 1985; 53: 521–5.PubMedGoogle Scholar
  11. 11.
    Lee M-S, Chang K-S, Cabanillas F et al.: Detection of minimal residual cells carrying the t(14; 18) by DNA sequence amplification. Science 1987; 2: 175–9.CrossRefGoogle Scholar
  12. 12.
    Crescenzi M, Seto M, Herzige GP et al.: Thermostable DNA polymerase chain amplification of t(14; 18) chromosomal breakpoints and detection of minimal residual disease. Proc Natl Acad Sci USA 1988; 85: 4869–72.PubMedCrossRefGoogle Scholar
  13. 13.
    Berliner N, Ault K, Martin P et al.: Detection of clonal excess in lymphoproliferative disease by K/? analysis: Correlation with immunoglobulin gene DNA rearrangement. Blood 1986; 67: 80–5.PubMedGoogle Scholar
  14. 14.
    Lindh J, Johansson H, Lenner P et al.: Monoclonal B-cells in blood in non-Hodgkin lymphoma. Correlation with clinical features and prognoses. Acta Oncol 1989; 28: 641–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Lindemalm C, Mellstedt H, Biberfeld P et al.: Clonal blood B-cell excess in relation to prognosis in untreated non-leukemic patients with non-Hodgkin’s lymphoma (NHL). In: Malignant Lymphomas and Hodgkin’s Disease: Experimental and Therapeutic Advances. Cavalli F, Bonadonna G, Rozencweig M (ed.). Martinus Nijhoff Publishing, 1985; 225–32.CrossRefGoogle Scholar
  16. 16.
    Lennert K.: Malignant lymphomas other than Hodgkin’s disease. In: Handbuch der speziellen pathologischen Anatomie and Histologie. Volume I/3 Lymph Nodes Part B. Berlin, Springer Verlag, 1978.Google Scholar
  17. 17.
    Tycko B, Palmer JD, Link MP et al.: Polymerase chain reaction amplification of rearranged antigen receptor genes using junction-specific oligonucleotides: Possible application for detection of minimal residual disease in acute lymphoblastic leukemia. In: Cancer Cells 7/ Molecular Diagnostics of Human Cancer, Cold Spring Harbor Laboratory, 1989; 47–52.Google Scholar
  18. 18.
    Hansen-Hagge T, Yokota S, Bartram C.: Detection of minimal residual disease in acute lymphoblastic leukemia by in vitro amplification of rearranged T-cell receptor delta chain sequences. Blood 1989; 74: 1762–7.PubMedGoogle Scholar
  19. 19.
    Deane M, Norton J.: Detection of immunoglobulin gene rearrangement in B lymphoid malignancies by polymerase chain reaction gene amplification. Br J Haematol 1990; 74: 251–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Lindh J, Lindström A, Lenner P et al.: Immunoglobulin heavy-chain gene rearrangement in peripheral blood mononuclear cells in non-Hodgkin’s lymphoma — Correlation with kappa:lambda analysis and clinical features. Eur J Haematol 1989; 42: 134–42.PubMedCrossRefGoogle Scholar
  21. 21.
    Horning S, Galili N, Cleary M et al.: Detection of non-Hodgkin’s lymphoma in the peripheral blood by analysis of antigen receptor gene rearrangements: Results of a prospective study. Blood 1990; 75: 1139–45.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1991

Authors and Affiliations

  • Anna Johnson
    • 1
  • Eva Cavallin-Ståhl
    • 1
  • Måns Åkerman
    • 2
  1. 1.Departments of OncologyUniversity Hospital of LundSweden
  2. 2.Departments of Pathology & CytologyUniversity Hospital of LundSweden

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