Establishment and characterization of an EBNA-negative human lymphoma cell line (BHL-89)

BACKGROUND

The aim of the work was to establish human malignant lymphomas in culture, in order to study the biological characteristics and drug sensitivity of lymphomas of human lymphoid origin.

MATERIALS AND METHODS

Lymph nodes of patients were explanted and kept in cultures using conventional tissue culture methods. Cytogenetic methods were used for karyotype analysis. Clonogenic assay was applied to test drug sensitivity. The tumorigenic capacity of the cells was determined by inoculating them into immunosuppressed mice. Immunological and other markers were examined with conventional techniques.

RESULTS

A cell line, BHL-89, was established in culture from a patient with B-cell type non-Hodgkin's malignant lymphoma. Cells started to grow after a few days without a feeder layer in stationary suspension. The population doubling time was 48 h. The cells were hyperploid, and non-random aberrations were +1, -15, +14q+. Cloning efficiency in soft agar was found to be as high as 50-60%. The cells expressed markers characteristic of early B cells. The BHL-89 cells were Epstein-Barr nuclear antigen (EBNA) negative. They produced tumors when 10(7) cells were injected into immunosuppressed mice. The cells were sensitive to dibromodulcitol (Elobromol), an alkylating antitumor drug, and resistant to the phorbol ester TPA.

CONCLUSIONS

The established EBNA-negative BHL-89 cell line has a few unique characteristics, e.g. rapid establishment without feeder cells, origin from the lymph node of an adult patient, high clonogenicity in soft agar, and resistance to TPA. The cell line is suitable for studying the nature of B lymphomas and testing compounds against lymphoproliferative disorders.

Low activity of the classical complement pathway predicts short survival of patients with chronic lymphocytic leukaemia

The activities of the classical (CP) and alternative (AP) complement pathways as well as the levels of some complement components and circulating immune complexes were measured in 43 patients with chronic lymphocytic leukaemia (CLL) between 1980 and 1984. Depressed CP activities were frequently found in these patients. Clinical course of the disease in the patients was followed until 1992, and compared with the initial complement values. During the follow-up period 36 patients died, death of 33 patients being related to the underlying disease. A strong positive correlation (P < 0.01) was found between the length of survival of the patients and the initial CP values. Patients were divided into two groups: group A, short-term survivors, i.e patients who died in CLL-related complications within 3 years after the complement measurements; and group B, long-term survivors who died > or = 4 years after the complement measurements due to any cause, or were alive at the end of the follow-up period. Average CP values in Group B were almost twice those in group A (P = 0.002), and a similar but less pronounced difference was found in C3 levels (P = 0.055). These differences were even more marked (P = 0.0006 and P = 0.0015, respectively) when only patients in Rai stage 2 and 3 were considered. Low classical pathway activities predicted short survival time: according to the logrank test, patients in Rai stage 2-3 with low (< mean - 2s.d. of the normal values), and normal CP levels survived for 2.0 +/- 1.1, and 4.6 +/- 3.0 years, respectively. All the nine and 11/13 patients with low CP and C4 levels, respectively, died within 3 years after the complement measurements were made. These findings indicate that complement measurements performed in CLL patients have a clinical value.

Immunologic and molecular biologic characterization of pleural involvement in a case of T-chronic lymphocytic leukemia

Pleural involvement is a rare complication of chronic lymphocytic leukemia (CLL). We report a CLL case of T-cell origin (documented by cell surface marker as well as DNA rearrangement studies) where the lymphoid cells of the pleural fluid were found to belong to the same monoclonal population of T cells as those of the peripheral blood.

[Experience with the molecular genetical detection of the chimera gene of the Philadelphia chromosome]

Molecular genetical techniques could be developed for detection of the chimera gene of Philadelphia chromosome or that of its gene product, due to the relatively conserved structure of the chimera gene. The authors successfully analysed 123 blood/bone marrow samples from 106 patients using these molecular techniques adapted from the literature. Patients were classified by the first diagnosis, 65 CML, 7 AML, 13 ALL patients were studied. 12 patients had the diagnosis of myeloproliferative syndrome, and 9 patients were after bone marrow transplantation. 57% of the total, and by diagnosis, 74% of CML, 28% of AML, 54% of ALL, and 33% of post-transplant samples have shown the chimera gene structure characteristic for Philadelphia chromosome. All patients of myeloproliferative syndrome were negative. In some cases the authors had the opportunity to study simultaneously the peripheral blood and the bone marrow sample of the same patient and of the same date. The ratio of the positivity of the two samples varied from one to infinite. The authors could follow the effect of interferon in one case, the change of clonality of the leukemic cell line in an other case. They had the opportunity to detect two different abnormal gene structures in the sample of an AML patient.

Autoantibody occurrence in hairy cell leukemia

BACKGROUND

Autoimmune syndromes accompanying hairy cell leukemia (HCL) may represent a specific entity in HCL patients. It has been claimed that interferon (IFN)-alpha therapy contributes to the occurrence of autoantibodies in HCL. The study was undertaken to determine the occurrence of autoantibodies in HCL patients prior to IFN-alpha therapy.

PATIENTS AND METHODS

Sera of 24 patients with HCL of B-cell origin (as determined previously by peripheral blood mononuclear cell surface markers and/or DNA rearrangement studies) were investigated. In addition serum from a T-HCL patient was studied. Nineteen of the 25 HCL patients had been splenectomized prior to the study. One patient was found to have IgM lambda monoclonal protein in her serum. Antinuclear antibodies were determined with an indirect IF test using Hep-2 cells. Rheumatoid factors of the IgM and IgA classes were determined by enzyme-linked immunosorbent assay (ELISA). Granulocyte-specific antinuclear antibodies and antineutrophil cytoplasmic antibodies were determined by indirect immunofluorescence.

RESULTS

No clinical syndrome of an autoimmune disease was apparent in any of our HCL-patients. Rheumatoid factors of either IgM or IgA class were found in the sera of six B-HCL patients and antinuclear antibodies in five cases, while anti-cytoplasmic antibodies were identified in only three cases. The occurrence of antibodies seemed to be independent of the clinical stage of the disease as determined according to the functional criteria. Two patients with arthralgias and one with vitiligo had no autoantibodies in their sera.

CONCLUSIONS

Autoantibodies might occur in HCL patients prior to treatment with interferon-alpha and in the absence of the clinical syndrome of an autoimmune disease.

Clinical applications of phenotypic analysis

The ability to track lymphocyte differentiation and activation via the expression of cell surface marker molecules has had an enormous impact on diagnosis, monitoring and therapy of a wide range of diseases. Here, Katalin Pálóczi highlights studies from Hungary on the clinical applications of such analysis.

[Importance of the detection of minimal residual disease in the management of acute leukemia]

Between 1984-1988, 57 adult acute leukemic patients were treated with intensive combined chemotherapy in the National Institute of Haematology and Blood Transfusion. For the evaluation of response to therapy, 4 investigations were performed in parallel: bone marrow aspirate, bone marrow biopsy, cytogenetic analysis and bone marrow culture. Nonparametric test for samples taken for the evaluation of remission status showed that bone marrow biopsy was significantly the most sensitive method for the detection of residual disease. The bone marrow culture was also on the borderline of significance, but the low CFU-GM level did not always correlate with the further clinical course. Occasionally, karyotypic abnormality was the only sign of the residual disease. It would be of great importance to quantitate the minimal residual disease in order to evaluate and compare the various intensive postinduction therapeutic strategies.

The complement system in HIV disease

Different aspects of the relationship between the HIV infection and the complement system were studied. 1. No significant differences were found between seronegative controls, asymptomatic, and symptomatic (ARC, AIDS) HIV-seropositive patients in the plasma levels of complement components C4, Bf, and C3. 2. Using sensitive ELISA assays, a significant increase was observed in the levels of protein-protein complexes which are formed at the activation of the classical (C1r-C1s-C1-INH) and alternative (C3b-Bb-P) pathways, indicating that both complement pathways are activated in the HIV disease. No significant differences were found, however, in the levels of these complexes between the groups of asymptomatic and symptomatic HIV-infected patients. 3. Artificial immune complexes of synthetic peptides representing some immunodominant epitopes of HIV envelope (gp120, and gp41) proteins, and human polyclonal anti-HIV IgG were found to weakly activate both the classical and alternative complement pathways. 4. An elevated percentage of the lymphocytes carrying a complement activation fragment, C3d, was detected in the blood of HIV seropositive patients as compared to the seronegative controls. No significant positive correlation was found between the percentage of these cells and that of any T cell subsets tested.

Immunoglobulin profiles and antibacterial antibody levels in hairy cell leukaemia

Serum immunoglobulin and natural antibody concentrations to environmental antigens have been determined in 26 hairy cell leukaemia (HCL) patients. The serum IgG, IgA and IgM levels as well as the concentration of antibodies to the majority of intestinal bacteria were found to be normal in both groups of HCL patients. In contrast to the data on the impaired humoral immunity of chronic lymphocytic leukaemia (CLL) patients, our results show that in HCL the studied aspects of humoral immunity are normal. Serum IgE levels were found to be significantly decreased in HCL when all patients were taken as a group. The difference was due to the decreased serum IgE concentration of splenectomized HCL patients, while IgE levels of untreated HCL patients did not differ statistically from that of the healthy controls.

Neutralizing and complement-dependent enhancing antibodies in different stages of HIV infection

Reclustering and indirect immunofluorescence assays on MT-4 cells [carrying both CD4 and complement receptor type 2 (CR2)] were used to measure neutralizing and enhancing antibodies in sera obtained from HIV-1-infected individuals. Heat-inactivated sera were tested before and after mixing 1:1 with fresh seronegative human serum. Using heated samples, neutralizing antibodies were found in 20 out of 20 and 11 out of 19 serum samples of asymptomatic and symptomatic [AIDS, AIDS-related complex (ARC)] HIV-seropositive patients, respectively. In complement-restored samples, neutralizing activity was found in eight sera of asymptomatic patients and in none of the sera of AIDS and ARC patients; enhancing activity could be detected in four and 12 sera, respectively. A significant positive correlation was observed between the titres of neutralizing antibodies measured in the complement-restored samples and the absolute number of CD4+ lymphocytes. These findings indicate that the appearance of complement-dependent enhancing antibodies coincident with the loss of neutralizing antibodies may indicate a poor prognosis in HIV infection.

Correlation of the percentage of activated, CD3 + DR + lymphocytes to serum neopterin level in HIV-seropositive haemophiliacs

The percentage of activated, CD3+ DR+ and CD8+ Leu7+ lymphocytes and the serum neopterin concentration were determined in 17 HIV-seropositive and 10 HIV-seronegative haemophiliacs and in 11 healthy control subjects. All three parameters tested were found to be significantly higher in the seropositive patients than in the seronegative controls. In the seropositive group, a significant positive correlation was found between the neopterin levels and the percentage of CD3+ DR+ cells. By contrast, no significant negative or positive correlation was observed between the neopterin levels and the percentage of the CD8+ Leu7+ subset. These data suggest that in the HIV-infected patients the activated T cells responsible for the stimulation of macrophages to produce neopterin are those that do not carry CD8.

[Heterogeneity of surface antigens in chronic B-cell lymphoid leukemia]

Clinical and immunological studies of fifty patients with CLL have been performed. No correlation was found either between the clinical stage or clinical course of the disease and the distribution of cell surface makers characteristic of CLL (CD19, CD20, CD21, HLA-DR, sIg). Therapy did not influence the distribution of B lymphocyte subpopulations. On the other hand we recognized differences when examining the B-cell specific features. The CD21 antigen was present in significantly lower proportion when compared to all other B-cell markers. This suggests the presence of immature B-cell population. Correlation studies showed a strong correlation between the presence of the CD5 antigen and the antigens CD19, CD20, HLA-DR and sIg, while a similar correlation could not be proved between the CD5 antigen and CD21 marker. Thus the application of the CD5 antibody together with any of the B-cell markers seems to be sufficient for the diagnostics of CLL with the exception of the CD21 antibody that marks only a small proportion of the B-cell population in CLL, so it can be used for purposes of clinical diagnostics.

Differences in non-MHC restricted cytotoxic activities of human peripheral blood lymphocytes after transfusion with allogeneic leukocytes or platelets possessing class I and/or class II MHC molecules

MHC-unrestricted cytotoxic activity of peripheral blood lymphocytes (PBL) from 4-6 healthy donors was investigated before and after transfusion with allogeneic leukocytes or platelets. Natural killer and lectin-dependent cellular cytotoxicity (LDCC) of PBL was tested against K562 and Raji target cells in a 4-h and 16-h 51Cr-release assay, respectively. After allotransfusion with leukocytes, we found increased cytotoxic activity of each donor's PBL against all the three targets on day 3 or 7. The highest non-specific cytotoxic activity was detected against the relatively NK resistant Raji target cells. The increase of cytotoxic activity was lowest against the LDCC target (PHA-treated Raji) cells. On the contrary, no changes in cytotoxic activity against any targets were observed after allotransfusion with platelets (possessing class I HLA antigens but no HLA class II molecules). Our results suggest that HLA class II molecules, presumably by inducing immune responses, are essential for activation/generation of non-specific killing of tumor targets after leukocyte transfusion. Thrombocytes, known to be less immunogenic than leukocytes, are not effective in in vivo enhancing of non-specific cytotoxicity. Cellular activation of PBL following leukocyte allotransfusion was confirmed by detection of elevated serum neopterin and beta-2-microglobulin levels on day 3. This was not the case after platelet allotransfusion. In addition, the expression of ICAM-1 antigen (as a molecule involved directly in MHC-unrestricted cytotoxicity) was also found to be increased in two donors' PBL on day 3 after leukocyte transfusion in contrast to transfusion with platelets.

Age dependency of the progression of HIV disease in haemophiliacs; predictive value of T cell subset and neopterin measurements

Sixteen HIV-seropositive haemophiliacs were followed up for 42 months and 9 other patients for 24 months. All patients were infected in 1983 or 1984. T cell subsets and serum neopterin levels were measured twice a year. The patients were divided into three groups according to their age in 1989: group A (children) less than 14 years old (n = 6); group B (adolescents) 14-20 years old (n = 8); group C (adults) greater than 20 years old (n = 11). At the last measurement performed in November, 1989, patients of group A had significantly higher absolute number and percentage of CD4+ lymphocytes and significantly lower serum neopterin levels than patients of group B and C. In addition, the percentage of the activated, CD3+ DR+ lymphocytes was also significantly higher in the adult-adolescent group than in the children group. Until the end of December, 1989, AIDS developed in 0, 1 and 2 patients and ARC was diagnosed in 0, 5, and 2 patients of groups A, B, and C, respectively. The progression of the HIV disease towards AIDS in these patients was predicted by the T cell subset and neopterin measurements performed in 1987. Only those 3 patients who progressed to AIDS had CD4+ cells less than 350/microliters and a neopterin value of more than 20 nmol/l. These findings confirm previous observations indicating that in patients with haemophilia the progression of HIV disease is influenced by age: a relatively slow progression can be expected in prepuberty children.(ABSTRACT TRUNCATED AT 250 WORDS)

Activation of lymphocytes after platelet allotransfusion possessing only class I MHC product

After platelet allotransfusion, we found a characteristic increase in the expression of interleukin-2 receptor, dipeptydilpeptidase IV (CD26), activation-inducer molecule (AIM, CD69) and transferrin receptors (CD71) on day 3 indicating that important functional molecules expressed on the activation of lymphocytes by allogeneic platelets. At the same time, no consistent increase of other activation molecules such as Ki-l (CD30), intercellular adhesion molecule (ICAM-1, CD54) and Ki-24 (CDw70) antigen expression was detected, probably as a result of the selective activation of some lymphocyte subsets. In order to obtain further evidence for the in vivo activation triggered by allogeneic platelets, subsequent step of T cell activation towards differentiation was investigated with monoclonal antibodies to leucocyte common antigens. A sharp expression of the UCHL1, coupled with a decrease of the CD45R molecule was detected on day 7 or 14, suggesting a T cell priming.

Immunoglobulin profiles and antibacterial antibody levels in 50 patients a long time after posttraumatic splenectomy

Serum immunoglobulin and antibacterial antibody concentrations have been determined in 50 patients 2 to 20 years after posttraumatic splenectomy. The serum levels of IgG, IgA and IgM were found to be significantly greater in the group of posttraumatic splenectomy patients than in that of the healthy controls. The serum IgE concentrations did not differ statistically from that of the controls. The serum level of natural antibodies against intestinal bacteria were found to be elevated (Shigella 1b, 2a, 3 and Salmonella typhi 02 strains) or normal (Salmonella typhi 0901 as well as E Coli 026 and 055 strains). Our results show that the studied functional aspects of humoral immunity in this group of otherwise healthy splenectomized individuals were not impaired.

Development of chronic lymphocytic leukaemia after posttraumatic splenectomy

In the course of a post-splenectomy follow-up study, 2 out of 102 patients who had been splenectomized after an abdominal trauma were found to have developed chronic lymphocytic leukaemia 5 and 31 years after splenectomy, respectively. The possible association between splenectomy and secondary leukaemia is discussed.

[Cytochemical, immunologic and gene rearrangement studies in adult acute leukemia]

Results of morphological, cytochemical and immunological studies performed in adult acute leukaemias have been compared. Thirty one cases proved to be acute myeloid leukaemia, while 25 cases were shown to be acute lymphoid leukaemia. Based on our results we conclude that immunophenotyping with monoclonal antibodies does not help in distinguishing the subtypes of AML. For purposes of clinical diagnosis cytochemical methods are valuable. On the other hand the monoclonal antibodies are essential in distinguishing the very immature myeloid and lymphoid leukaemias and this is of great importance from the clinical point of view, in determining therapy. Moreover, the diagnosis of acute lymphoid leukaemias is not possible without the specific monoclonal antibodies. Their application is first of all in haematological centers caring for leukaemia patients nowadays already obligatory. Gene rearrangement studies make the diagnosis more accurate and help in the diagnosis of leukaemias of unknown immunological origin.

[Gene rearrangement in leukemia]

In this report we summarize our experiences based on the gene rearrangement study of 111 leukaemic patients of different kind. The lymphocyte DNA of the patients was studied for rearrangement of the immunoglobulin light chain constant-, the heavy chain joining- and the T cell receptor beta chain constant region. Our data have well supplemented the results of the monoclonal antibody experiments. In 33 cases the DNA study was in good agreement with the immunological data. In 42 our data helped in gave different results, immunological results. In 11 cases evaluating the DNA and immunological data indicating the necessity of further investigation. The results were inconclusive in 25 cases. As a conclusion we consider the gene rearrangement study to be useful for diagnostic purposes.

Observations on NK cells, K cells and on their function a long time after posttraumatic splenectomy

Natural killer (NK) cell activity and antibody-dependent cellular cytotoxicity of 48 posttraumatic splenectomy patients was found to be normal despite the increase in the proportion and the absolute number of large granular lymphocytes (LGLs). The NK cell activity of 2 further posttraumatic splenectomy cases was severely decreased, despite elevated number of LGLs and normal number of CD16+ peripheral blood mononuclear cells. Besides increased susceptibility to upper respiratory tract infections, 1 of these patients developed herpes genitalis recidivans. Two posttraumatic splenectomy patients were found to have developed chronic lymphocytic leukemia 5 and 31 years following splenectomy, respectively.

Immunological and molecular biological identification of a true case of T-hairy cell leukaemia

A hairy cell leukaemia (HCL) patient is presented in whom the peripheral blood mononuclear cells (PBMCs) carried suppressor T-cell markers (CD3+, CD2+, CD8+/CD4-, CD38+). Analysis of genomic DNA of PBMNC showed the presence of a monoclonal population of T cells, the T-cell receptor (TCR) beta-chain gene being rearranged on both alleles (DR/DR), while the immunoglobulin (Ig) heavy chain-genes were in germline configuration. The neoplastic cells were found to react with the monoclonal antibody RAB-1 - originally described as belonging to the B lineage-restricted monoclonal antibodies - and to carry RAB-1/CD-8 in a double marker assay. Natural killer activity of PBMNCs against K562 target cells was severely reduced, while the cells were found to exert strong antibody-dependent cellular cytotoxicity.