Circulating monoclonal B lymphocytes in non-Hodgkin's lymphoma.
Circulating monoclonal B lymphocytes in non-Hodgkin's lymphoma.
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非霍奇金淋巴瘤中的循环单克隆 B 淋巴细胞。
DOI：
10.1056/nejm198412063112304
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Ault,KA
中科院分区：
文献类型：
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作者：
Smith,BR;Weinberg,DS;Robert,NJ;Towle,M;Luther,E;Pinkus,GS;Ault,KA
使用敏感的流式细胞术方法（“κ-λ分析”），我们发现单克隆B淋巴细胞在血液中的91例非霍奇金淋巴瘤患者。B淋巴细胞的存在与患者疾病的组织学亚型无关。当我们同时分析活检获得的肿瘤组织中的表面轻链类型时，23例患者中有21例的血液单克隆细胞的表观轻链类型与肿瘤的表观轻链类型相对应（P = 0.03）。血液中这些细胞的存在与淋巴瘤累及骨髓的形态学证据无关，但与临床分期有很强的相关性。在长期临床缓解期间进行的研究表明，25例结节性非霍奇金淋巴瘤患者中有16例持续存在单克隆淋巴细胞，14例弥漫性组织细胞性淋巴瘤缓解期患者均无上述表现（P<0.005）。我们对B-细胞克隆过剩表明，在淋巴瘤患者完全缓解期间，复发的可能性很高，但我们在淋巴瘤缓解期患者中没有发现这些细胞，其中延长缓解期与治愈相关。淋巴瘤患者循环中的单克隆淋巴细胞可能是恶性细胞，缓解后它们的消失或持续存在可能具有预后意义。（N Engl J Med 1984; 311：1476-81.）
Using a sensitive flow cytometric method ("kappa–lambda analysis"), we have found monoclonal B lymphocytes in the blood of 71 of 91 patients with non-Hodgkin's lymphoma. The presence of the B lymphocytes was independent of the histologic subclassification of the patient's disease. When we performed simultaneous analysis of the surface light-chain type in tumor tissue obtained by biopsy, the apparent light-chain type of the blood monoclonal cells corresponded with that of the tumor in 21 of 23 patients (P = 0.03). There was no correlation of the presence of these cells in the blood with morphologic evidence of bone-marrow involvement by lymphoma, but there was a strong correlation with clinical staging. Studies performed during prolonged clinical remission showed that whereas 16 of 25 patients with nodular non-Hodgkin's lymphoma had persistence of monoclonal lymphocytes, none of the 14 patients with diffuse histiocytic lymphoma in remission had these findings (P<0.005).Our analysis for B-cell clonal excess demonstrates the persistence of circulating monoclonal lymphocytes during complete remission in patients with forms of lymphoma that have a high probability of relapse, but we did not find these cells in patients in remission from categories of lymphoma in which prolonged remission is associated with cure. It is possible that the circulating monoclonal lymphocytes in patients with lymphoma are malignant cells, and their disappearance or persistence after remission may have prognostic importance. (N Engl J Med 1984; 311: 1476–81.)