Viral Outcome in Patients with Occult HBV Infection or HCV-Ab Positivity Treated for Lymphoma

ABSTRACT HBV and HCV reactivation has been widely reported in patients undergoing immunosuppressive therapy for oncohaematological diseases. We aimed to evaluate the HBV and HCV reactivation events in patients with non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL) underwent cytotoxic chemotherapy containing or not rituximab. This is a retrospective observational study, including all patients with NHL and HL attending an Italian tertiary referral hospital, the University of Naples "Federico II". A total of 322 patients were enrolled. We evaluated serum HBV and HCV markers. A total of 47 (38%) patients with occult HBV infection were enrolled. Seven/47 were treated with therapeutic cytotoxic schedule containing rituximab. Of them, 6/7 received prophylaxis with lamivudine. HBV reactivation was observed in two patients treated with rituximab. A reactivation was observed in the only patient (HBcAb+/HBsAb+) not receiving lamivudine prophylaxis, and the other one was observed in 1 patient with isolated HBcAb positivity during lamivudine prophylaxis. Moreover, 8 patients with HCV-Ab positivity were enrolled. No viral reactivation was observed in these patients. In conclusion, patients with occult HBV infection receiving chemotherapy containing rituximab for lymphoma without antiviral prophylaxis are at risk of viral reactivation. On the contrary, there is no risk of reactivation in patients undergoing rituximab-free schedule. Our findings suggest that there is also very low risk of HCV reactivation. This preliminary report underlines the concept that HBV reactivation is strongly related to the type of immunosuppressive therapy administered and that antiviral prophylaxis needs to be tailored.

Morphological Typing of Lymphomas with Immunohistochemistry.

Lymphoid malignancies (LM) are a heterogeneous group of disorders that are broadly divided into Hodgkin disease (HD) and Non-Hodgkin Lymphoma (NHL). Diagnosing lymphoid malignancies based on morphology in conjunction with immunohistochemistry (IHC) forms the basis of WHO classification and this has prognostic implications.With this background this study was designed thus including all the lymphoid malignancies both NHL and HD. Materials and Methods: This study was conducted at a tertiary centre in Uttarakhand and included a total of 116 cases of lymphoid malignancies. Of these 41 cases were of Hodgkin disease and 75 cases were of NHL. These cases were initially diagnosed on morphology employing Hematoxylin and Eosin (H&E) and special stains like Reticulin. Subsequently, a preliminary panel of monoclonal antibodies using CD3, CD15, CD20, CD30, and CD45 were employed. All the cases were then classified using WHO classification. Results: HD- Of the 41 cases of Hodgkin’s disease the commonest subtype was Nodular Sclerosis seen in 26 cases (48.78%). Reed Sternberg in reactive milieu is diagnostic of Hodgkin disease. In all cases except one Reed Sternberg cells exhibited positivity for both CD15 and CD30. NHL – Of the 75 cases of NHL an initial classification based on morphology was done. All the cases were classified according to International Working Formulation initially. Subsequently, IHC was employed using CD3, CD15, CD20 and CD45. The disease was then classified according to WHO classification and broadly divided into B or T cell types. B cell expression was seen in 60 cases (80%) and T cell expression in 15 cases (20%). The commonest B cell subtype was Diffuse Large B cell Lymphoma (26.4%).

Foliculitis necrotizante herpética / Necrotizing herpes folliculitis. Report of one case

Herpes folliculitis is a rare manifestation of herpes virus infection. It usually represents a diagnostic challenge, due to the absence of characteristic skin manifestations such as vesicles or pustules. The reported cases are mainly associated with varicella zoster virus (VZV) and less commonly with herpes simplex viruses (HSV-1 y HSV-2). We report a 51-year-old male with a relapsing non-Hodgkin Lymphoma under chemotherapy, with history of extensive follicular lesions lasting one month. The pathologic study of the lesions was consistent with necrotizing herpes folliculitis. The patient was treated with Valacyclovir, achieving remission of the lesions. The appearance of folliculitis, especially in an immunocompromised patient, should raise the suspicion of herpes virus infection. Polymerase chain reaction may help to elucidate the diagnosis when pathologic findings are non-specific.

Complement dependent cytotoxicity activity of therapeutic antibody fragments is acquired by immunogenic glycan coupling

Oligosaccharides are implicated in the development of the immune response notably in complement activation. Anti-tumoural immunotherapy by monoclonal antibodies (mAbs) offers some advantages to chemotherapy including cell targeting but some of them are inefficient to generate cytotoxicity dependent complement (CDC) known to be important in the antibody’s efficacy. The aim of this study is to give a CDC activity of mAb by linkage of a complement activating oligosaccharide to this antibody via a hetero-bifunctional linker allowing control of the conjugation reaction. We worked on non Hodgkin Burkitt’s lymphoma as cancer source, Fab fragments of rituximab devoid of complement activity as mAb and the trisaccharide Gal alpha(1→3)Gal beta(1→4)GlcNAc as immunogenic glycan. The bioconjugate Fab-Gal was characterized by biochemical methods and we demonstrated that the α-Gal epitope was recognized by seric immunoglobulins. After checking the recognition capacity of the Fab-Gal conjugate for the CD20 epitope, in vitro assays were performed to evaluate the activation of the complement cascade by the Fab-Gal conjugate. The effect of this bioconjugate was confirmed by the evaluation of the proliferation response of Burkitt’s cell line. The relative facility realization of this strategy represents new approaches to increase activities of mAbs.

Antiphospholipid antibodies and multiple organ failure in critically ill cancer patients

OBJECTIVES: To describe the clinical outcomes and thrombotic events in a series of critically ill cancer patients positive for antiphospholipid (aPL) antibodies. DESIGN: Retrospective case series study. SETTING: Medical-surgical oncologic intensive care unit (ICU). PATIENTS AND PARTICIPANTS: Eighteen patients with SIRS/sepsis and multiple organ failure (MOF) and positive for aPL antibodies, included over a 10-month period. INTERVENTIONS: None MEASUREMENTS AND RESULTS: aPL antibodies and coagulation parameters were measured up to 48 hours after the occurrence of acrocyanosis or arterial/venous thrombotic events. When current criteria for the diagnosis of aPL syndrome were applied, 16 patients met the criteria for "probable" and two patients had a definite diagnosis of APL syndrome in its catastrophic form (CAPS). Acrocyanosis, arterial events and venous thrombosis were present in eighteen, nine and five patients, respectively. Sepsis, cancer and major surgery were the main precipitating factors. All patients developed MOF during the ICU stay, with a hospital mortality rate of 72 percent (13/18). Five patients were discharged from the hospital. There were three survivors at 90 days of follow-up. New measurements of lupus anticoagulant (LAC) antibodies were performed in these three survivors and one patient still tested positive for these antibodies. CONCLUSIONS: In this small series of patients, we observed a high frequency of auto-antibodies and micro- and macro-vascular thrombotic events in critically ill cancer patients. The coexistence of sepsis or SIRS and aPL antibodies was often associated with MOF and death. More studies are necessary to determine the pathophysiological significance of antiphospholipid antibodies in severely ill cancer patients.

Inmunoquimioterapia en linfoma no Hodgkin indolente (LNHI) / Immunochemotherapy for non-hodkin indolent lyphomas

Actualmente esta bien establecido que la asociación de Rituximab (R) con quimioterapia (QT), inmunoquimioterapia, aumento la sobreviva global en pacientes (pts.) con LNHI.

Linfomas não-Hodgkin extranodais em Salvador-Bahia: aspectos clínicos e classificação histopatológica segundo a OMS-2001 / Extranodal non-Hodgkins lymphomas in Salvador, Brazil: clinical aspects and histopathological classification according to the WHO-2001 guidelines

Linfomas não-Hodgkin (LNH) extranodais representam cerca de um terço de todos os linfomas e atualmente apresentam taxa de incidência maior que a de linfomas nodais. Diferenças entre LNH nodais e extranodais incluem etiologia, formas de apresentação e resposta terapêutica, entretanto não dispomos de dados na nossa população. Este estudo teve como objetivo caracterizar os LNH extranodais diagnosticados no Hospital Aristides Maltez, em Salvador-Bahia. Foram avaliados, retrospectivamente, 145 diagnósticos de linfoma não-Hodgkin, segundo a OMS-2001, no período de janeiro de 1999 a julho de 2001. A freqüência de linfomas extranodais foi de 30,3 por cento. A idade média dos pacientes foi de 55,6 anos e a relação homem/mulher foi de 1:1. A maioria dos pacientes apresentava estadios avançados (III ou IV de Ann Arbor), presença de sintomas B, LDH normal, bom desempenho pela escala do ECOG e IPI entre zero e dois. Nove pacientes estão vivos e em remissão completa (22,5 por cento) após um seguimento médio de 23 meses. O sítio extranodal mais comumente acometido foram as tonsilas, seguidas pela cavidade oral, pele e trato gastrointestinal, dentre outros. O linfoma difuso de grandes células B foi o mais comum subtipo histológico, seguido pelo linfoma anaplásico de grandes células. Concluímos que o mais freqüente sítio extranodal de apresentação em nosso estudo difere da maioria da literatura, porém nossa freqüência de linfoma extranodal é semelhante à mesma.

Extranodal non-Hodgkins lymphomas represent approximately one third of all lymphomas and currently have an incidence higher than nodal lymphomas. Differences in etiology, presentation and outcome of these lymphomas have been reported. However, there are no data in our population. This study was carried out in the Pathological Anatomy Service of Aristides Maltez Hospital in Salvador, Bahia. One hundred and forty-five non-Hodgkins lymphomas cases according to the WHO-2001 classification detected between January 1999 and July 2001 were evaluated. The frequency of extranodal lymphomas was 30.3 percent. The mean age of the patients was 55.6 percent years and the male/female ratio was 1:1. The majority of the patients presented with advanced stages, B symptoms, normal LDH, ECOG between o and 2 and IPI between O and 2. Nine patients are still alive in complete remission (22.5 percent) with a mean follow-up of 23 months. The main extranodal sites were the tonsils followed by the oral cavity, skin and gastrointestinal tract. Diffuse large B-Cell lymphoma was the mains histological subtype, followed by anaplastic large-cell lymphoma. In summary, the mains extranodal site in our study was different from the masority of reports. However our extranodal lymphoma frequency was similar.

Expression of P-glycoprotein and BCL

Drug resistance is considered to be the major cause of failure of anticancer therapy in patients with malignancy negative regulator of apoptosis such as BCL 2 have also been considered. The aim of this work is to evaluate P-gp and BCL 2 expression level and its significant prognostic value in acute lymphoblastic leukemia [ALL] amid disseminated non-Hodgkin lymphoma [D-NHL]. Peripheral blood mononuclear cells from newly diagnosed cases [30 ALL, 30 D-NHL] and 20 healthy control subjects were collected. lmmunohistochemical staining of mononuclear cells using BCL 2, P-glycoprotein [P-gp] monoclonal antibodies. A Statistically significant increase of P-gp and BCL 2 expression on malignant cells was found in ALL and D-NHL cases compared to the normal control. No statistical significant difference in BCL 2 or P-gp expression in different immunopenotypic patterns, different FAB subtypes of ALL cases or different pathological types or grades of D-NHL cases. A significant statistical correlation was found between the level of BCL 2 and P-gp expression and decreased disease free survival [DFS] and over all survival [OS] in NHL and ALL cases. Assessment of multi drug resistance mechanisms based on both P-gp and BCL 2 expression level is suggested to be an important predictor of treatment outcome in ALL and D-NHL cases

Rosette formation in non Hodgkin's lymphoma in the bone marrow--a case report.

This is a case report of rosette formation in non-Hodgkin's lymphoma in the bone marrow. A 66 year old female on treatment for metastatic papillary carcinoma thyroid and non-Hodgkin's lymphoma of the nodular small cleaved cell type was found to have bone marrow infiltration by a low grade B cell lymphoma. Bone marrow aspirate, imprint and trephine biopsy showed rosettes of the abnormal lymphoid cells. The associations of papillary carcinoma thyroid, hyperglobulinemia and retroperitoneal fibrosis in this case which explain the histogenesis of rosette formation are discussed.

Immunophenotyping of childhood NHL in Iraq

Childhood NHL in Iraq was classified according to their cell of origin, using immunological markers available to be used in paraffin-embedded tissue sections. Thirty three children of both sexes from all parts of Iraq were included in this prospective study which was conducted for the period from December 1999- June 2001. Using streptavidin-biotin amplified immunoperoxidase immunostaining of paraffin-embedded tissue sections and different immunological markers specialized for T and B cells, CD30 and CD45. The results showed that all patient's biopsies were CD45 positive and most of the patients were of B-cells lymphoma, 9.1% of the patients were of T-cells lymphoma, and only 3.03% of the patients were of Ki-I positive large cell anaplastic lymphoma. We concluded that immunophenotyping of NHL are important factor for proper diagnosis and immunological characterization of childhood lymphomas, and also allows initiation of proper therapeutic approach as soon as possible

Estudo imunomolecular dos linfomas não hodgkin de origem B na infância: correlação clínica e terapêutica / B non-Hodgkin lymphoma immunological study in childhood: correlation with histological types and therapeutic response

A proteína p53 desempenha um papel central nas respostas celulares dentre as quais se incluem o controle do ciclo e da morte celular induzida por dano ao DNA, como aquele causado por muitos agentes quimioterápicos e radiação utilizados no tratamento do câncer. O propósito deste estudo foi descrever as funções biológicas da proteína p53 e investigar o seu papel nos linfomas não Hodgkin de origem B da infância. Adicionalmente, nós também estudamos os tipos histológicos e a prevalência da infecção pelo vírus Epstein-Barr e sua correlação com os achados clínicos patológicos. Uma série de crianças com linfoma não Hodgkin B foi estudada com relação aos subtipos histológicos, características clínicas, mutações do gene TP53 e expressão das proteínas p53, Ki-67 e mdm2. A detecção de mutações do gene TP53 foi realizada através da técnica de PCR-SSCP dos exons 5-8/9 e seqüenciamento direto em 49 do total de 61 pacientes da série. As mutações do gene TP53 foram detectadas em 22.5por cento dos pacientes analisados, em 20por cento dos pacientes com linfoma de Burkitt. A análise das seqüências destes casos mostrou a presença de mutações do tipo pontual em 10 casos e uma inserção em um caso. A expressão da proteína p53 por imunohistoquímica foi realizada em 48 do total de 61 pacientes com resultados positivos em 31por cento dos casos. A proteína mdm2 foi negativa em todos os casos testados (42casos), incluindo aqueles com mutação do gene TP53. Observou-se uma alta concordância entre a expressão da p53 e a presença de mutações (p=0.0005). Não foi detectada uma correlação estatisticamente significante entre mutações e os achados clínicos. A comparação da sobrevida livre de eventos entre os grupos com e sem mutação usando o teste de Long-Rank também não foi significante. O virus EBV foi analisado por hibridização in situ e estava associado ao LB em 72por cento dos tumores(21/29 pacientes). O tipo 1 infectou a maioria dos casos(28/29). Houve uma tendência de associação entre idade mais baixa e os casos de linfoma de Burkitt associados ao EBV (mediana de 4 anos comparada a 6 anos, respectivamente, p=0.057). Também o nosso estudo sugeriu que na região sudeste do Brasil o LB tem uma associação intermediária com o EBV. Em conclusão, este estudo permitiu contribuir para uma melhor caracterização imunofenotípica e molecular dos linfomas não Hodgkin B da infância no Brasil.

Estudo imunomolecular dos linfomas não hodgkin de origem B na infância: correlação clínica e terapêutica

A proteína p53 desempenha um papel central nas respostas celulares dentre as quais se incluem o controle do ciclo e da morte celular induzida por dano ao DNA, como aquele causado por muitos agentes quimioterápicos e radiação utilizados no tratamento do câncer. O propósito deste estudo foi descrever as funções biológicas da proteína p53 e investigar o seu papel nos linfomas não Hodgkin de origem B da infância. Adicionalmente, nós também estudamos os tipos histológicos e a prevalência da infecção pelo vírus Epstein-Barr e sua correlação com os achados clínicos patológicos. Uma série de crianças com linfoma não Hodgkin B foi estudada com relação aos subtipos histológicos, características clínicas, mutações do gene TP53 e expressão das proteínas p53, Ki-67 e mdm2. A detecção de mutações do gene TP53 foi realizada através da técnica de PCR-SSCP dos exons 5-8/9 e seqüenciamento direto em 49 do total de 61 pacientes da série. As mutações do gene TP53 foram detectadas em 22.5por cento dos pacientes analisados, em 20por cento dos pacientes com linfoma de Burkitt. A análise das seqüências destes casos mostrou a presença de mutações do tipo pontual em 10 casos e uma inserção em um caso. A expressão da proteína p53 por imunohistoquímica foi realizada em 48 do total de 61 pacientes com resultados positivos em 31por cento dos casos. A proteína mdm2 foi negativa em todos os casos testados (42casos), incluindo aqueles com mutação do gene TP53. Observou-se uma alta concordância entre a expressão da p53 e a presença de mutações (p=0.0005). Não foi detectada uma correlação estatisticamente significante entre mutações e os achados clínicos. A comparação da sobrevida livre de eventos entre os grupos com e sem mutação usando o teste de Long-Rank também não foi significante. O virus EBV foi analisado por hibridização in situ e estava associado ao LB em 72por cento dos tumores(21/29 pacientes). O tipo 1 infectou a maioria dos casos(28/29). Houve uma tendência de associação entre idade mais baixa e os casos de linfoma de Burkitt associados ao EBV (mediana de 4 anos comparada a 6 anos, respectivamente, p=0.057). Também o nosso estudo sugeriu que na região sudeste do Brasil o LB tem uma associação intermediária com o EBV. Em conclusão, este estudo permitiu contribuir para uma melhor caracterização imunofenotípica e molecular dos linfomas não Hodgkin B da infância no Brasil.

p53 protein plays a central role in cellular responses, including cellcycle arrest and cell death in response to DNA damage such as that caused by many chemotherapeutic agents and radiation used in cancer therapy. The purpose of this study is to provide an outline of the biological functions of p53 and assess the role of p53 in clinical settings of childhood B non-Hodgkin's lymphoma. In order to contribute to the characterization of the B non-Hodgkin's lymphoma in this country, we also studied the prevalence and type of EBV infection and its correlation with demographic and clinical pathologic data. We investigated a series of patients with childhood B non-Hodgkin's lymphoma for hystological subtypes, clinical profiles, TP53 mutations and immunohistochemistry expression of p53, Ki-67 and mdm2 proteins. Screening for p53 mutations was made by polymerase chain reactionstrand conformational polymorphism analysis of exon 5 to 8/9 of the gene and direct sequencing in 49 out of 61 patients. Mutations of TP53 were detected in 22.5% of patients analyzed and more specifically in 20% of Burkitt's lymphoma. The sequence analysis showed missense mutations in 10 cases and an insertion in one case. The p53 immunostaining positivity was performed in 48 out of 61 patients. The overall frequency of p53 immunostaining positivity was 31 %. The mdm2 expression was negative in all cases tested (42 cases) including the patients with TP53 mutations. There was a very good agreement between expression and the presence of TP53 mutation (P = 0.0005). No significant correlation was found regarding age, gender, clinical stage and LDH level and TP53 mutations. Comparisons of EFS curves using the Logtest were also not significant. EBV was detected by in situ hybridization in 21 of 29 BL (72%) and 1 virus infected the majority of EBV positive BLs (18/21). There was a for younger age in children with EBV positive BL compared with EBV negative BL (median age of 4 years, compared to 6 years, respectively; p = 0.056 ). In addition, our study suggested that in the Southeast of Brazil, BL an intermediate association with EBV. In conclusion, with this study it was possible to contribute with a ecular and immunological profile of childhood B non - Hodgkin limphoma in children from Brazil.

Método de reação em cadeia por polimerase para a pesquisa de retrovírus em casos de linfomas não-Hodgkin de células T periféricas e paraparesias crurais espásticas / PCR methods for retrovirus search in cases of non-Hodgkin lynphoma of peripheral T-cells and crural spastic paraparesis

Partindo de dois oligonucleotídeos degenerados derivados de uma fração conservada da região pol de retrovírus conhecidos, foi pesquisada a presença de agente viral exógeno ou de uma seqüência endógena similar as retrovirais (ERV). A partir da amplificação do DNA pela técnica de PCR, foram testadas células mononucleares periféricas de 33 portadores de paraparesia crural espática de evolução crônica sem agente etiológico conhecido, produzindo um fragmento de aproximadamente 500 bp em 8 destas amostras...

Disminucion de los linfocitos CD3+ de sangre periferica en pacientes con linfomas / Decrase of CD3+ lymphocytes in the peripheral blood of lymphoma patients

Los anticuerpos monoclonales anti-celula T fueron probados por inmunoflorescencia sobre celulas mononucleares perifericas obtenidas de 99 pacientes con linfomas no Hodgkin (LNH), 84 con enfermedad de Hodgkin (EH) y 16 adultos sanos. El objetivo de este estudio es describir la expresion de antigenos de diferenciacion leucocitarios humanos CD3, CD4 y CD8 en los linfocitos circulantes de pacientes sin tratamiento previo. Las comparaciones de patrones de reactividad entre los pacientes y los adultos sanos permitio observar que las medias de los valores porcentuales de celulas CD3+ fueron estadisticamente diferentes (p<0,001), a expensas de una alta frecuencia de individuos con conteos bajos CD3+ en ambas entidades, asi como frecuentes alteraciones de las subpoblaciones CD4+ y CD8+, aunque con diferencias estadisticamente no significativas en cada grupo de pacientes en relacion con el control sano. El fenotipo CD3+, CD4+ CD8+ no logro discriminar las muestras de pacientes con EH de los LNH, como era lo esperado, dada la heterogeneidad de ambos procesos

Estudio comparativo entre las pruebas de ELISA e inmunodifunsión en el diagnóstico de la Leucosis Enzoótica Bovina / Comparative study of the agar gel immunodiffusion test and the ELISA test in the bovine enzootic lymphosarcoma

EL Linfosarcoma Enzoótico Bovino (LEB) es el problema neoplásico más común e importante por las pérdidas económicas que ocasiona, principalmente en el ganado lechero. En México escasea la información concerniente al LEB. El objetivo del presente trabajo fue comparar la efectividad de las pruebas de Inmunodifusión en gel de agar y ELISA para el diagnóstico de la enfermedad en sueros de bovinos Holstein Friesian. Se formaron tres grupos de 10 animales cada uno y uno cuarto grupo con 15 animales. El primero consistió en animales seropositivos con leucocitosis persistentes (LP), el segundo en seropositivos sin presentación enzoótica de la enfermedad y sin LP, y el tercero con LEB, comparados con un grupo testigo de 15 animales clínicamente sanos y negativos serológicamente al Virus de la Leucosis Bovina (VLB). Se obtuvieron tres muestras sanguíneas de cada animal con intervalos de un mes para cada una. Las dos pruebas resultaron ser igualmente específicas. Los mayores títulos de anticuerpos se detectaron en el grupo 1, sin correlación directa entre éstos y la presentación de la enfermedad. Los títulos de anticuerpos detectados con la prueba de ELISA no variaron durante los tres muestreos de los grupos infectados.

Secondary immune defects in non-Hodgkin's lymphoma.

Changes in the humoral, cellular and phagocytic components of the immune system were investigated in 44 biopsy proven, untreated patients of non-Hodgkin's lymphoma (NHL). There was significant decrease in the total lymphocyte number, their subsets (T and B) and the T helper (T mu) population. Impaired leukocyte migration inhibition response and DNA synthesis following stimulation by phytohaemagglutinin were noted. Significant reduction of serum IgA was found in patients of both diffuse and nodular NHL. Phagocytic activity and nitroblue tetrazolium (NBT) reduction were unaltered, but chemotaxis was significantly reduced and bactericidal activity showed variable results.

A clinicopathologic study on the diffuse malignant lymphoma: a morphologic and immunophenotypic analysis in 62 patients at Harbor-UCLA Medical Center

In order to compare the prognoses of patients with diffuse malignant lymphomas on the basis of histology and immunophenotypes, we retrospectively studied 62 cases of diffuse lymphoma arising in lymph nodes. We also evaluated the reactivity patterns of monoclonal antibodies (MoAb) LN1, LN2 and LN3 to determine the criteria for making a differential diagnosis in B cell lymphomas. The immunologic phenotypes were determined by the avidin biotin peroxidase complex method, using frozen or paraffin fixed tissues. The majority (66.3%) were B cell with the remaining 20.9% being T cell and 12.9% were non-B, non-T cell lineage. Immunological heterogeneity was found especially in the mixed small and large cell and the immunoblastic lymphomas. There was no significant difference between B- and T-cell lymphomas with respect to survival and death (P > 0.05). Histologically 79% (49/62) of the lymphoma was large cell and 21% (13/62), small cell lymphoma. There was a difference in prognosis between low, intermediate and high-grade of lymphomas. However there were no significant differences among the subtypes of the diffuse aggressive lymphomas. Factors associated with poor prognosis were advanced stages (P < 0.025) and histology of the malignant lymphomas. MoAb LN1, LN2 and LN3 gave positive staining in 83.3%, 91.7% and 60% of B cell lymphomas, respectively. The most common phenotypic pattern in B cell lymphomas was LN1+, LN2+, LN3+/-, suggestive of follicular center cell origin. As a panel, phenotypic patterns of MoAb LN1, LN2 and LN3 may be useful in differentiation of follicular center cell lymphoma from others.

Lymphoma associated antigen (LAA)--a unique biomarker for lymphomas.

A lymphoma associated antigen (LAA) isolated from pooled lymph nodes of confirmed Hodgkin's and non-Hodgkin's lymphomas has been purified and characterized. Using a xenogenic rabbit anti-serum, enzyme-linked immunosorbent assay (ELISA) and RIA were developed for LAA. LAA was detected in the sera of all confirmed lymphomas, the test being negative for normals, for patients with benign lymphadenitis and various other types of cancers. Except for a very few false positive results, no false negative was observed. LAA was identified in urine, CSF, saliva and gastric juice of a few lymphoma patients, and the test proved to be of diagnostic potential, as for a few patients it had a lead time of a few months over the histological diagnosis. In order to render the LAA test more precise and specific, monoclonal antibodies were generated by both in vitro and in vivo immunization procedures. Seven monoclonals were generated, viz. 7D6, 7D2, 7G2, 7C5, 6G2, 23B7 and 23G11, which exhibited cytoplasmic staining of frozen sections of malignant lymphoid tissues of B cell derived non-Hodgkin's lymphomas. Two of these monoclonal antibodies, 7D6 and 23B7, revealed strong cytoplasmic staining of frozen sections, impression smears and cytospin specimens of B cell non-Hodgkin's lymphomas. The reactivity was very weak or negative for T cell lymphomas. The test was negative for Hodgkin's disease and controls. These results were confirmed by dot blotting, immunoprecipitation and immunofluorescence study. By ELISA with a sensitivity of 15 ng/ml, serum LAA levels for lymphomas were in the range 72-1250 ng/ml. LAA could not be detected in the sera of normals and controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Serum immunoglobulins in leukaemia and malignant lymphoma.

The serum immunoglobulin levels were studied in 25 healthy control subjects and 23 cases of leukaemia (6 cases of acute lymphatic leukaemia, 5 cases of acute myeloid leukaemia, 2 cases of chronic lymphatic leukaemia and 10 cases of chronic myeloid leukaemia) and 17 cases of malignant lymphoma (13 cases of Hodgkin's lymphoma and 4 cases of non-Hodgkin lymphoma). The mean levels of IgG, IgA and IgM in 25 control subjects were 1573.56 +/- 91.45 mg/dl, 209.64 +/- 12.55 mg/dl and 109.81 +/- 10.03 mg/dl respectively, those in 23 cases of leukaemia were 1338.23 +/- 109.74 mg/dl, 195.53 +/- 20.72 mg/dl and 127.47 +/- 13.29 mg/dl respectively and those in 17 cases of malignant lymphoma were 996.99 +/- 99.50 mg/dl, 147.47 +/- 19.61 mg/dl and 129.35 +/- 19.95 mg/dl respectively. The mean levels of IgG and IgA were found to be decreased in cases of leukaemia with elevated levels of IgM, however, it was found to be insignificant (p less than 0.4). The mean IgG, IgA and IgM levels were found to be almost identical in different leukaemia irrespective of cytological types except in 2 cases of chronic lymphatic leukaemia which showed low levels of IgG and IgA. The mean levels of IgG and IgA were found to be significantly decreased in malignant lymphoma (p less than 0.02). IgM levels were found to be increased in 3 cases of non-Hodgkin lymphoma.