[NK- and T-cell granular lymphocyte-proliferative disorders]

For the disease of the granular lymphocytes (GL) that contain azurophilic granules to proliferate in the peripheral blood, which is often complicated by anemia or neutropenia and which generally develop into chronic disease, the new designation of granular lymphocyte-proliferative disorders (GLPD) is being proposed. This disease include T-GL having CD3 antigen which forms a complex with T cell Ag receptor (TCR-alpha beta), and NK-GL which is CD3-negative but CD16- or NKH-1-positive, having non-MHC-restricted cytotoxicity. The two cases presented here demonstrate the characteristics of T-GL or NK-GL, however, while one case with NK-GL showed spontaneous decrease of GL, improvement of neutropenia and anemia without any treatment, the other case with T-GL became intractable and required repeated blood transfusion. On such differences in the clinical development of the disease, we have conducted investigations including a review of the literature to see whether there is any correlation between the characteristics of the proliferating cells and pathologic conditions of the disease, and whether this disease is indeed tumorous.

Establishment of five human myeloma cell lines

Five human myeloma cell lines, KMM-1, KMS-5, KMS-11, KMS-12-PE, and KMS-12-BM, have been established at Kawasaki Medical School since 1980. As the KMS-12-PE and KMS-12-BM lines were obtained from the same patient, these five cell lines have been derived from four patients with multiple myeloma. The five myeloma cell lines are stably growing at present in RPMI 1640 medium supplemented with 10% fetal bovine serum. They can also grow in a defined culture medium without serum. That these cell lines were human myeloma cells was confirmed by the following findings. Ultrastructurally, all five cell lines showed features characteristic of plasma cells. KMM-1 and KMS-11 cells secreted lambda and kappa chains into the culture medium, respectively, but the other cell lines produced no immunoglobulins. KMM-1 expressed cytoplasmic lambda antigen, KMS-5 showed cytoplasmic delta, and KMS-11 expressed surface kappa, whereas KMS-12-PE and KMS-12-BM cells showed no surface or cytoplasmic immunoglobulins. Regarding reaction with a monoclonal plasma cell antibody (PCA-1), four of the five lines were positive, the exception being KMS-5. Another monoclonal antibody (CD38), which also recognizes plasma cells, responded to KMM-1, KMS-12-PE, and KSM-12-BM. KMS-5 cells expressed acute lymphoblastic leukemia antigens (CALLA). These data suggest that such lines as KMM-1, KMS-11, KMS-12-PE, and KMS-12-BM represent later stages of B-cell differentiation, and that KMS-5 represents a relatively early stage of B-cell differentiation. All the cell lines lacked Epstein-Barr virus nuclear antigen, showed abnormal karyotypes of human origin, and differed from each other in the isozyme patterns examined. Only KMS-5 was tumorigenic when transplanted subcutaneously into nude mice.

[Treatment of multiple myeloma with LAK cells plus interleukin 2 or interleukin 2 alone]

Three patients with multiple myeloma were treated with 3.3-10 x 10(5) u/day intravenous or subcutaneous IL 2 alone. Both their Leu7 and CD16 positive cells in the peripheral blood and NK and LAK cell activity elevated but no M protein decreased. LAK cells and IL-2 administered to three patients intravenously. Lymphocyte counts in the peripheral blood elevated remarkably in one patient and CD3, 8, 16, 2, 38, Leu7 positive cells and NK cell activity increased in three patients. Though the reduction of M proteins were observed in three patients (17%, 75.8% and 40%, respectively), they returned to pretreatment level in 35 days, 55 days and 200 days after the therapy. Significance of the therapy against multiple myeloma was discussed.

Glucocorticoid receptor in multiple myeloma

Glucocorticoid receptor levels of myeloma cells were quantitated in 7 patients with multiple myeloma. In 4 patients, glucocorticoid receptor levels were less than 10 fmol/10(6) cells. In 3 patients, receptor levels were from 17.6 to 21.4 fmol/10(6) cells. We further examined the correlation between glucocorticoid receptor levels and effect of dexamethasone on 14C-thymidine incorporation and cell viability using 2 myeloma cell lines, OPM-1 and OPM-2, established from a patient with multiple myeloma. Glucocorticoid receptor levels of OPM-1 and OPM-2 were 8.5 fmol/10(6) cells and 63.2 fmol/10(6) cells, respectively. The sensitivity of OPM-1 to dexamethasone in these studies was lower than that of OPM-2. These results suggest the possibility that the low level of glucocorticoid receptor in myeloma cells may be important for predicting a poor response to glucocorticoid therapy.

Establishment and characterization of adult T-cell leukemia virus-containing B-cell lines derived from peripheral blood of adult T-cell leukemia patients

B-cell lines which showed predominantly surface IgA kappa immunoglobulins were established from each of seven adult T-cell leukemia (ATL) patients. ATL virus proviral DNA was found in five of the lines. Though the chromosomal analysis of the B-cell lines yielded normal results, fresh leukemic T-cells showed chromosome abnormalities.

B-cell differentiation antigen expressed on a human myeloma cell line (KMM-1)

KMM-1 is a human multiple myeloma cell line previously shown to express plasma cell phenotypes. Hybridomas against this cell line were produced by fusing spleen cells from hyperimmunized BALB/c mice with X63-Ag8-653 mouse myeloma cells. One monoclonal antibody derived from this fusion, termed 33-3, reacted with all the B-cell stages except the pre-B-cell stage. Both myeloma cells from patients and those from KMM-1 cells were reactive at the same maximum dilution of this antibody. No reactivity was seen with cells of T-lymphocyte origin, platelets, red blood cells, monocytes or granulocytes. The 33-3 antibody was unable to detect any specific marker distinguishing cultured myeloma cells from those that could not be cultured in vitro.

Adult T-cell leukemia. Chromosome analysis of 15 cases

Chromosome studies was conducted on 15 patients with adult T-cell leukemia. Cells with chromosomal abnormality were seen in 14 of the 15 patients. The modal chromosome number was near diploid range in all the patients. The most common abnormality was 14q+ marker chromosome and partial deletion of the long arm of chromosome 6, i.e., 6q-, which were seen in eight and seven cases, respectively. Donor chromosomes involved in the 14q+ marker chromosome varies, i.e., Yq, #5p, #5q, #9q, #10q or #12q, except for two patients whose donor chromosome origins were unable to determine. The break point in 14q+ marker chromosome was band at q32. The 6q- chromosome was due to a deletion in one patient and interstitial deletion in six patients. A 14q- chromosome having break point at q24 was found in one patient and duplication of Yq chromosome in two patients. In addition, four patients showed a 5q- chromosome or a 9q- chromosome which was due to a translocation or deletion. The significance of these chromosome abnormalities was discussed.

Establishment and characterization of a human myeloma cell line (KMM-1)

A new cell line (KMM-1) was established from a subcutaneous plasmacytoma of a 62-year-old male with multiple myeloma. Immunological studies indicated that cultured cells were derived from the same clone of myeloma cells in vivo: smeared cells were stained with fluorescein-conjugated globulin of antisera monospecific to lambda-chain, and lambda-chains in the cell extracts and in culture media were identical to the Bence-Jones protein found in the patient's urine. The cell line grew in suspension with prominent nucleoli and rough endoplasmic reticulum. Cells had the karyotype of 47, X, -Y, Iq+, -2, +t(1:2) (cen:cen), +7, 12q+, 14q+, +mar and carried no Epstein-Barr virus-determined nuclear antigen. Surface markers were as follows; E rosette (-), IgG Fc receptor (-), C3 receptor (-), S-Ig (+), TdT (-), asialo-GM1 (-). The reasons for the successful establishment of the myeloma cell line are discussed.