nuclear proliferation antigen in chronic lymphoproliferative disease

ABSTRACT

To determine whether the proliferation rates of tumour cells, in chronic lymphoproliferative disorders may reflect disease activity and relate to prognosis, we studied the expression of ki-67% [a nuclear proliferation marker] by alkaline phosphatase anti-alkaline phosphatase technique [APAAP], in peripheral blood and bone marrow mononuclear cells [separated on Ficoll-Hypaque] and in lymph-node biopsies, from patients with chronic lymphatic leukemia [CLL], chronic lymphatic leukemia/prolymphocytic leukemia [CLL/PLL], prolymphocytic leukemia [PLL] and non-Hodgkin's lymphoma with leukemic phase. The proliferation rate was determined for these patients at presentation and again two months after therapy [to detect any change with therapy]. We found that the highest rate of proliferation in each group was parallel to the degree of malignancy i.e. PLL showed higher proliferation than CLL/PLL, and CLL/PLL showed higher proliferation than CLL. In the NHL group the highest proliferation rate was found in the high-grade NHL. followed by intermediate grade NHL then the low grade NHL Lymph node biopsies also showed the same relation between proliferation rates and degree of malignancy. Bone marrow cells did not show a particular pattern probably due to interference from the erythroid element and contamination by peripheral blood. Ki-67% was compared to other proliferation markers serum B2 micro globulin and lactate dehydrogenase, It was found to be an independent marker of proliferation it is unaffected by hepatic, renal and gastrointestinal elements and thus its specificity for the tumour proliferation