Circulating lymphoma cells in patients with B & T non-Hodgkin's lymphoma detected by immunoglobulin and T-cell receptor gene rearrangement

Abstract

We studied peripheral blood mononuclear cells from 50 patients with active B- and T-cell non-Hodgkin's lymphoma by DNA hybridisation. Nineteen patients (38%) had circulating clones of cells detected by immunoglobulin gene rearrangement (17 patients) or T-cell receptor gene rearrangement (2 patients) with JH and J beta 2 probes. Lymphoma tissue and peripheral blood were studied simultaneously in 22 patients, 9 of which had a circulating clone of cells in peripheral blood. In 7 patients the gene rearrangement in lymphoma tissue and peripheral blood mononuclear cells was identical. However, in 2 patients both heavy chain and light chain gene rearrangements were different in tissue and peripheral blood. The incidence of peripheral blood involvement was commonest in advanced CSIII & IV disease (54%) compared to CSI & II disease (18%) (P less than 0.05), and in low grade (45%) compared to intermediate and high grade lymphoma (31%) (difference not statistically significant). Only 4 patients had definite lymphoma cells seen on peripheral blood smear. The presence of circulating lymphoma cells correlated with conventional assessment of bone marrow involvement although circulating clones were detected in 30% (12/40) of patients with apparently normal bone marrow. Images Figure 1 Figure 2 Figure 3

Peripheral blood involvement in non-Hodgkin's lymphoma detected by clonal gene rearrangement as a biological prognostic marker

“…In ten patients in this study lymphoma tissue was available for analysis, and in four cases in which rearrangement was found in peripheral blood this was identical to that in the lymphoma tissue. This is similar to previous findings and indicates that such gene rearrangement represents lymphoma cells (Brada et al, 1987;Hu et al, 1985). As shown previously, the sensitivity of detection of lymphoma cells was 1-5% (Berliner et al, 1986;Brada et al, 1987;Horning et al, 1990).…”

“…This is similar to previous findings and indicates that such gene rearrangement represents lymphoma cells (Brada et al, 1987;Hu et al, 1985). As shown previously, the sensitivity of detection of lymphoma cells was 1-5% (Berliner et al, 1986;Brada et al, 1987;Horning et al, 1990). The overall frequency of detection of lymphoma cells (31%) compares with other studies (Brada et al, 1987;Horning et al, 1990;Johnson et al, 1991), which suggest that similar sensitivity was retained.…”

“…The overall frequency of detection of lymphoma cells (31%) compares with other studies (Brada et al, 1987;Horning et al, 1990;Johnson et al, 1991), which suggest that similar sensitivity was retained. The rate of detection correlated with stage, histological grade and the presence of bone marrow involvement as reported previously (Brada et al, 1987;Homing et al, 1990). Although the presence of circulating cells was related to the stage of disease and bone marrow involvement, a number of patients with early stage disease and without bone marrow involvement had clonal rearrangement in peripheral blood.…”

“…As shown previously, the sensitivity of detection of lymphoma cells was 1-5% (Berliner et al, 1986;Brada et al, 1987;Horning et al, 1990). The overall frequency of detection of lymphoma cells (31%) compares with other studies (Brada et al, 1987;Horning et al, 1990;Johnson et al, 1991), which suggest that similar sensitivity was retained. The rate of detection correlated with stage, histological grade and the presence of bone marrow involvement as reported previously (Brada et al, 1987;Homing et al, 1990).…”

“…Circulating lymphoma cells can be detected with 1-5% sensitivity (Brada et al, 1987;Knowles et al, 1987;Wright et al, 1987), and this is more sensitive than the technique of clonal excess (Berliner et al, 1986). The sensitivity can be markedly increased by the use of polymerase chain reaction (PCR).…”