A study of surface markers in acute lymphocytic leukemia by using anti-T and anti-B lymphocyte sera

Non-Hodgkin's lymphoma of Waldeyer's ring and nasal cavity. Clinical and immunologic aspects

Twenty-nine cases of non-Hodgkin's lymphoma of Waldeyer's ring (W-NHL) and nasal cavity or paranasal sinus (N-NHL) were studied for tumor-surface marker phenotype and histopathologic correlation with clinical features. Immunostaining procedures on tissue sections by using xenoantisera and monoclonal antibodies to human B- and T-cells enabled the authors to demonstrate precise surface marker phenotypes of tumor cells and, moreover, the histologic localization of normal or neoplastic B- and T-cells in preserving the original structure of lymphoid organs or tumor tissues. In 22 cases of W-NHL, 19 (86%) had B-cell markers and 3 (14%) had T-cell markers, whereas 6 of 7 cases (86%) of N-NHL had T-cell markers. Tumor cells in T-cell lymphomas in W-NHL and N-NHL reacted with antibodies to peripheral T-cells except one case of W-NHL. Rappaport "histiocytic" subtype was heterogeneous with respect to both surface marker characteristics and morphologic features, i.e., seven had B-cell markers and four had T-cell markers, and they were all subdivided into "large cell" or "large cell, immunoblastic" in Working Formulation and "large cell" or "pleomorphic" in Lymphoma Study Group classification. The actuarial survival curve for all T-cell lymphoma patients was characterized by a rapid initial decline and a subsequent plateau, which contained two of the long survivors. In contrast, the B-cell lymphoma group had a more graded decline. The median and actuarial survivals of the T-cell lymphoma group were far inferior to those for the lymphoma group that expressed B-cell markers.

Early deaths in acute lymphoblastic leukemia (ALL): results of the Italian Pediatric Cooperative Group for Therapy of Acute Leukemia (AIL-AIEOP)

In this retrospective multicentric study, we report on early deaths (ie, those that occurred during the first month of treatment) in a total of 943 newly diagnosed ALL pediatric patients registered from 1976 to 1981 at 21 centers of the AIL- AIEOP . Objectives of this study were as follows: (1) to verify the incidence and the cause of early death in a wide population of children with ALL and (2) to elucidate factors associated with early death and therefore to identify "high-risk" groups of patients. Out of the 943 ALL patients, 39 (4.1%) early deaths were registered. Main causes were infection, 20 patients (51.3%); hemorrhage, 11 patients (28.3%); uric acid nephropathy, 2 patients (5.1%); cardiac failure, 3 patients (7.6%); syndrome of inappropriate antidiuretic hormone secretion, 1 patient. Two patients died during the first week of unknown cause. Thirteen factors measured at diagnosis and possibly influencing the early death rate were analyzed. Using the chi-square test, only three of these factors (age, mediastinum status, surface markers) appear to have any significant influence on the early death rate. We also tried to determine how therapy influences this process by analyzing variations in the early death rate, other factors being equal. Significant differences in the early death rates were encountered in AIEOP protocols using different induction regimens.

Evolution of infectious mononucleosis into Epstein-Barr virus carrying monoclonal malignant lymphoma

A monoclonal malignant lymphoma was diagnosed in a 30-month-old Japanese boy, who, since the age of 12 months, had had chronic, recurrent infectious mononucleosis manifested by repeated episodes of severe cough and high fever accompanied by marked lymphadenopathy and hepatosplenomegaly and high serum Epstein-Barr virus (EBV) antibody titres. The diagnosis of Burkitt's lymphoma was made when a cervical lymph-node biopsy specimen revealed massive proliferation of immature B-cells with starry-sky histiocytes. These lymph-node cells were characterised by a translocation between chromosomes 10 and 17. There were approximately 9 EBV genome-equivalents per cell. Most cells were positive for nuclear antigen (EBNA); early antigen (EA) and viral capsid antigen (VCA) were also detected. The presence of EBV was supported by finding that the cell-free lymph-node extract transformed cord-blood lymphocytes into EBNA-positive blast cells. The proportion of EA-positive and VCA-positive cells increased rapidly in culture for 24 h, then the positive cells degenerated rapidly and completely. The cells also contained numerous herpes-type virus particles. The child improved considerably with cytostatic treatment and has been in remission for 2 years.

Surface antigenic phenotypes of human T-cell leukemia corresponding to those of post-thymic T cells

Leukemic cells from eight adult patients with various types of T-cell leukemias, including one patient with lymphosarcoma cell leukemia (T-LSL), two patients with chronic lymphocytic leukemia (T-CLL), and five patients with adult T-cell leukemia (ATL), were analyzed for their surface antigenic phenotypes with a series of monoclonal antibodies directing to human T-cell differentiation antigens. All of the leukemic T cells studied were regarded as being of post-thymic T-cell origin because of their ability to form rosettes with sheep red cells under the condition at 4 degrees C but not 37 degrees C as well as the expression of human Ly-1-like but not TL-like antigen on their cell surfaces. By using monoclonal antibodies to a variety of human of three distinct categories. Thus, one patient with T-LSL had cells with Leu-1+2a+3a+ phenotype, which might reflect possible post-thymic precursor T cells, whereas one patient with T-CLL had cells with the same phenotype (Leu-1+2a+3a-) as normal cytotoxic/suppressor T cells. The latter cells also expressed Ia antigens as defined by monoclonal antihuman Ia antibody. The remaining six cases, including one T-CLL and five ATL patients had leukemic cells with the same phenotype (Leu-1+2a-3a+) as normally found on helper/inducer T cells, despite distinct clinical and immunological features between T-CLL and ATL. Some clinical findings observed in those patients may reflect functional activities retained by their leukemic T cells.

Identification of lymphocyte subpopulations in human breast cancer tissue and its significance: an immunoperoxidase study with anti-human T- and B-cell sera

Subpopulations of the infiltrating lymphocytes in breast cancer tissue from 31 patients were identified by indirect immunoperoxidase technique with antihuman T- and B-cell sera. In all noncancerous lesions examined (seven cases), B-cells were predominant and T-cells were scarcely found. In contrast, T-cells were predominant in breast cancer tissues (17 in 21 cases). T-cells tended to contact closely with cancer cells or cancer cell nests and accumulated around and in the walls of venules draining the cancer, while B-cells tended to cluster focally apart from cancer cell nests. T-cell infiltration was scanty in scirrhus carcinoma, whereas it was ample in infiltrating papillotubular carcinoma which had a better prognosis. There was a significant reverse correlation between the intensity of the T-cell infiltration and the clinical stages. The intensity of the T cell infiltration was significantly high in patients without lymph node metastasis. These facts suggest the possibility that the infiltrating T-cells in cancer tissue represent host resistance against cancer and that the intensity of the T cell infiltration correlates with the clinical prognosis of the breast cancer patients.

A study of surface markers in non-Hodgkin's lymphoma by using anti-T and anti-B lymphocyte sera

Cell surface markers of 44 cases of non-Hodgkin's lymphoma (NHL) were studied with various surface markers, especially by using antihuman B lymphocyte serum (ABS), antihuman thymocyte serum (ATS-T), and antihuman peripheral T lymphocyte serum (ALS-T), which were rendered specific for human B lymphocytes, human thymocytes, and human peripheral T lymphocytes, respectively. An immunofluorescent study with ABS, ATS-T, and ALS-T enabled us to demonstrate the histologic localization of normal or neoplastic B and T cells in preserving the original structure of lymphoid organs or tumor tissues. The proportion of cell types in NHL was B cell type 59%, T1 (ATS-T reactive) type 7%, T2 (ALS-T reactive) type 23%, and Null (non T, non B) type 11%. The relationships among cell types, histologic findings, and clinical characteristics were also investigated. Patients with T1-NHL had mediastinal tumors, which were histologically classified into "Lymphoblastic lymphoma." These facts suggest that T1-NHL may have originated in the thymus. Patients with T2-NHL showed a high incidence of skin lesions. Median survival of ten patients with T1- and T2-NHL was seven months, which was much shorter than that of B- or Null-NHL.

Immunologic classification of childhood acute lymphocytic leukemia

Immunologic approaches to the classification of acute lymphocytic leukemia (ALL) have led to a new awareness of the heterogeneity of this disease. Surface membrane markers including surface membrane immunoglobulin, complement receptors, and sheep erythrocyte (E) receptors have demonstrated at least three subtypes of ALL, which include non-B, non-T, ALL, T-ALL, and B-ALL. In addition, hetero-antisera to Ia-like antigens and ALL-associated antigens have been used to positively identify non-B, non-T ALL, which was previously a diagnosis of exclusion. This paper reports 17 cases of childhood ALL whose lymphoblasts were studied for surface membrane immunoglobulin, sheep erythrocyte receptors, and the presence of four antigens detected by well-characterized heteroantisera. Every non-B, non-T lymphoblast was positively identified by the Ia-like antiserum and/or the ALL antiserum. One T lymphoblast was identified by E receptors and the T antiserum, whereas two did not have E receptors but did react to the T antiserum. None of these three T lymphoblasts reacted with the Ia-like antiserum.

Some problems on the histopathological diagnosis of non-Hodgkin's malignant lymphoma -- a proposal of a new type

A new classification for non-Hodgkin's malignant lymphoma is proposed as the one suited for the Lymphomas in Japan, which is to provide a new subtype "pleomorphic" for those more or less rapid-growing lymphomas of peripheral T-cell nature, along with another subtype lymphoblastic, after Nathwani et al. for those of central T-cell nature. The proposal is based on the result of the investigation by the Study Group for Histopathological Diagnosis on Malignant Lymphoma that (1) the presence of a significant number of T-cell lymphomas with peculiar "pleomorphism" is responsible for the very low reproducibility rate of histopathological diagnosis on the diffuse, mixed L&H type of Rappaport classification, and (2) the relative incidence of lymphoms as peripheral T-cell nature including the so-called adult T-cell leukemia is much higher in Japan than in the Western countries.