Diagnostic value of clonality of surface immunoglobulin light and heavy chains in malignant lymphoproliferative disorders

• Published in: American journal of hematology Vol. 43; no. 4; p. 265
• Main Authors: Batata, A, Shen, B
• Format: Journal Article
• Language: English
• Published: United States 01.08.1993
• Subjects: Cloning, Molecular; Diagnosis, Differential; Flow Cytometry; Humans; Immunoglobulin Heavy Chains - analysis; Immunoglobulin Heavy Chains - immunology; Immunoglobulin Light Chains - analysis; Immunoglobulin Light Chains - immunology; Immunophenotyping; Leukemia, Lymphocytic, Chronic, B-Cell - diagnosis; Leukemia, Lymphocytic, Chronic, B-Cell - immunology; Leukemia, Lymphocytic, Chronic, B-Cell - pathology; Lymphocytosis - diagnosis; Lymphocytosis - immunology; Lymphocytosis - pathology; Lymphoma, Non-Hodgkin - diagnosis; Lymphoma, Non-Hodgkin - immunology; Lymphoma, Non-Hodgkin - pathology; Lymphoproliferative Disorders - diagnosis; Lymphoproliferative Disorders - immunology; Lymphoproliferative Disorders - pathology; Receptors, Antigen, B-Cell - analysis; Receptors, Antigen, B-Cell - immunology
• ISSN: 0361-8609
• DOI: 10.1002/ajh.2830430407

Cell suspensions from the peripheral blood of B-chronic lymphoid leukemias (B-CLL, n = 274) and reactive lymphocytosis (RLC, n = 132) and from solid tissue samples of B-non-Hodgkin's lymphoma (B-NHL, n = 466) and reactive lymphadenopathy (RLA, n = 324) were analyzed to evaluate the diagnostic value of clonality of L- and H- chains in B-CLL and B-NHL. Cutoff levels for monoclonal L-chain (mono-L) and monoclonal H-chain (mono-H) were defined. In B-CLL, the association patterns of L- and H- chains were as follows: mono-L/mono-H, 245 cases (89.42%); mono-L/polyclonal H chain (poly-H), 4 (1.46%); polyclonal L chain (poly-L)/mono-H, 2 (0.73%); poly-L/poly-H, 2 (0.73%); undetected (und)-L/mono-H, 6 (2.19%); and und-L/und-H, 15 (5.47%). In B-NHL, the association patterns were mono-L/mono-H, 433 cases (92.92%); mono-L/poly-H, 4 (0.86%); poly-L/mono-H, 8 (1.72%); poly-L/poly-H, 2 (0.43%); und-L/mono-H, 4 (0.86%); and und-L/und-H, 15 (3.22%). Monoclonality of H chains are complementary to L-chain restriction, especially in the cases with poly-L or und-L, and should be considered as a positive criterion in determining surface immunoglobulin (SIg) clonality. Monoclonality of SIg assessed by both L and H chains is both sensitive and specific for the diagnosis of B-CLL and B-NHL, and their differentiation from RLC and RLA, since none of the cases of RLC and RLA showed monoclonal SIg.