The significance of B-clonal excess in peripheral blood in patients with non-Hodgkin’s lymphoma in remission
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.
KeywordsComplete Remission Lymphocyte Count Minimal Residual Disease Differential White Blood Cell Count Blood Lymphocyte Count
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- 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
- 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
- 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.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.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