[Differentiation of human blood lymphocytes by immunologic and autoradiographic methods. I. Results in normal individuals and patients with chronic lymphadenosis]

Terminal deoxynucleotidyl transferase (TdT) and membrane receptors in human leukemia and lymphoma -- first experience with lyophilized cells

Surface marker analyses and TdT assays were performed on cells from 31 patients. A variety of diagnoses were made and categorized as follows: acute leukemia (group I), non-Hodgkin lymphoma (group II) and diverse diagnoses (group III). Levels of TdT in the range from 0 to 7.9 U/mg lyophilized blasts from the peripheral blood were found in AL. This corresponds to 0-95 U/10(8) cells. Preparations of mononuclear cells from the peripheral blood of healthy donors showed TdT values up to 0.88 U/mg or 10.6 U/10(8) cells. High TdT activity was observed in a patient with AML, type M1 according to the FAB classification. In a patient with ALL (L1) cytostatic treatment effected the clearance of TdT activity from the peripheral blood cells and at the same time induced a significant increase of E rosette forming cells. Combined studies of the TdT activity and cell surface markers may enable us to define remissions and relapses of AL more precisely than it is possible by conventional cytological methods. Within the group II two patients with moderate TdT activities of 1.2 and 1.28 U/mg, respectively, were observed whose cells were of prolymphocytic or unclassifiable appearance, respectively. The TdT assay may be helpful to identify such cells of unknown origin and in addition may provide the means of discrimination between such cases and ALL patients who mostly show high TdT activities. Another result of our studies was the finding of moderate TdT activity of 1.2 U/mg with cells from the pleural effusion of a patient with Hodgkin's disease. Cells from malignant effusions from a patient with melanoma and a patient with teratoid carcinoma showed no TdT activity. Cells form the peripheral blood and from the bone marrow of a patient with blast crisis of CML showed TdT activity of 1.52 and 2.72 U/mg, respectively. Two other patients with blast crisis were negative. Not TdT activity was found in leukemic plasma cells. Our results show that lyophilized cells can be used for determinations of TdT activity. This greatly facilitates multi-parameter studies including cytological, cell surface marker and biochemical analyses.

Surface markers on peripheral blood lymphocytes of patients with follicular lymphoma suggesting a clonal origin

PBL of 14 patients with FL were examined by membrane fluorescence using anti-Ig antibodies (mu, gamma, delta; kappa, lambda), spontaneous rosette formation with SRBC and rosette formation with SRBC coated by antibody-complement complexes (EAC). Eight of the patients were untreated. In 3 patients monoclonal Ig were detected in the serum or urine. 7 patients exhibited clonal proliferation as judged by analysis of surface Ig. In addition, normal or elevated figures for EAC rosettes were found. The strong expression of S. Ig in PBL of FL patients is in contrast to the findings in CLL and multiple meloma, the increase of EAC-rosettes is shared by myeloma patients. It follows that membrane properties of PBL as studied in this work is of value in the diagnosis of malignancies of the B-cell system.

E1Lymphocytopenia in pseudo-lupus-erythmetaosus syndrome

Seven female patients with pseudo-lupus erythematosus (LE)-syndrome had markedly reduced lymphocyte counts in their peripheral blood during the active phase of the disease. One patient, we were able to study during the active phase of her disease, had a diminuation of spontaneous rosettes-forming (T-)lymphocytes, using neuraminidase-treated sheep red blood cells for the test. In this case the percentage of surface-immunoglobulin-bearing (B-)lymphocytes determined by an indirect immunofluorescence technique was augmented. In comparison with 20 normal controls 6 other patients did not show any alterations in the relation of B- and T-lymphocytes in the peripheral blood. 5 patients had circulating lymphocytotoxic antibodies in their serum. A specificity of these antibodies for T-lymphocytes could not be realized.

Immunological characterization of lymphoproliferative disorders by membrane markers

The characterization of lymphocyte subpopulations by means of surface markers improved our understanding of the immunopathology of lymphoproliferative disorders. In chronic lymphocytic leukemia an accumulation of B-lymphocytes have been documented. The antibody deficiency syndrome in these patients might well reflect a maturation defect of the leukemic B-lymphocytes. In patients with Hodgkin's disease the relative number of B- and T-lymphocytes in the blood was not markedly altered in comparison to normal controls. An increased proliferation primarily of T-lymphocytes however, might suggest their accelerated turnover as an indication of the host response. In most patients with "Non-Hodgkin" lymphomas high numbers of B-lymphocytes were found in affected lymph nodes, and these appear occasionally in the peripheral blood. Differences in immunopathological manifestations of the various subgroups of the "Non-Hodgkin" lymphomas are emphasized and the rare occurrence of lymphomas of T-lymphocytes (mainly observed in lymphoblastic lymphomas and in Sézary syndrome) is discussed. Immunopathological alterations in immunocytomas and the myelomas are considered in respect to the involvement of B-lymphocytes at different stages of maturation.

[Electronmicroscopic and immunohistochemical studies on human lymphocytes]

Lymphocytes from the blood of healthy individuals and of patients suffering from CLL were investigated by electron microscopy and peroxidase-immunohistochemistry. B-lymphocytes were labelled by heterologous, peroxidase-conjugated antisera directed against the Id-determinants of their membranes. T-lymphocytes were labelled by an indirect method: specific incubation with a specific anti-T-cell-globulin from the rabbit; labelling-incubation with a peroxidase-conjugated anti-rabbit-IgG-globulin from the sheep. In addition, T-lymphocytes were identified by their ability to form rosettes with sheep erythrocytes spontaneously. The quantitative results were: about 80% T-lymphocytes and about 24% B-lymphocytes in normal persons, the opposite results in CLL. T- and B-lymphocytes were photographed electron microscopically; the number of organelles in the single cells was evaluated: lysosomes in the average are more numerous in T-lymphocytes, ergastoplasm in B-lymphocytes, mitochondria are equally distributed in both groups of cells. There is so much overlapping, however, that the single cell only with the aid of immunochemistry or rosette formation can be identified as a B- or T-cell. In both, the T- and the B-cell-series, different forms of lymphocytes can be distinguished according to the degree of cell differentiation. Some further problems, as specificity of the antisera and labelling of the cells by means of their Fc-receptor are discussed.

[Deposits of immunoglobulins in the cells of chronic lymphocytic leukemia (author's transl)]

Cristalloid inclusions were demonstrated in the perinuclear space and the ergastoplasm of cells of chronic lymphocytic leukemia. These inclusions and the immunoglobulins of the cell membrane consisted of IgG. The leukemic cells were able to synthesize, but not to secrete, monoclonal immunoglobulins.

[Haematological and immunological findings in bone marrow aplasia (author's transl)]

The cellularity of the bone marrow, the number of blood cells and the immunoglobulins were investigated in 51 patients suffering from bone marrow aplasia. In this disease not only is a haematopoietic organ disturbed, but disorders of the lymphocyte and of the monocyte-systems can be detected too: the majority of patients show lymphocytopenia and monocytopenia. Immunologic reactions seem to be involved in the pathogenesis of bone marrow aplasia. The plasma cells of the bone marrow are elevated in nearly all of the patients, lymphocytes in every second case. One or several fractions of immunoglobulins are increased in about 50% and diminished in 25% of the patients.