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Use of Monoclonal Antibodies, Morphology, and Cytochemistry to Probe the Cellular Heterogeneity of Acute Leukemia and Lymphoma¹

Departments of Laboratory Medicine and Pathology [T. W. L., R. W. M., C. S. A., K. J. G-P., R. D. B., J. H. K.], Pediatrics [M. E. N., P. F. C., J. H. K.], and Medicine [C. D. B], University of Minnesota Health Sciences Center, Minneapolis, Minnesota 55455

A combined immunological, morphological, and cytochemical approach to the study of malignant cells in patients with acute leukemia and lymphoma is presented. Newly produced monoclonal antibodies that bind to antigens of human mononuclear cells (TA-1), or B-lymphocytes (BA-1) were used to study malignant cells from patients with acute lymphoblastic leukemia (ALL), acute myelocytic leukemia, acute myelomonocytic leukemia, and chronic lymphocytic leukemia. Results in lymphoid leukemia-lymphoma patients were compared with other immunological markers and indicate that the major groups of ALL and childhood non-Hodgkin's lymphoma are T-ALL, pre-T-ALL, pre-B-ALL, B-ALL, and non-T, non-B-ALL. In addition, each major group had multiple phenotypes when analyzed with seven immunological markers including the erythrocyte rosette receptor, surface immunoglobulin, cytoplasmic immunoglobulin M, the early lymphocyte-acute lymphoblastic leukemia antigen, monoclonal antibody TA-1, monoclonal antibody BA-1, and a monoclonal antibody against HLA-DR. While immunological heterogeneity was demonstrable within each group, distinct biological behavior was observed, with T-ALL and B-ALL generally presenting as "lymphomas" and the others presenting as "leukemias." Morphological analysis using the French-American-British classification provided independent information in the definition of groups with differing clinical behavior. Cytochemical analyses demonstrated focal paranuclear staining of leukemia cells with acid phosphatase in 73% of T-ALLs and 6% of non-T, non-B-ALLs.

¹ Presented at the Conference on Cell Markers in Acute Leukemia, March 4 and 5, 1980, Bethesda, Md. Supported in part by Grants CA-21737 and CA-25097 and Contract CB-84261 from the USPHS.

² Recipient of a Young Investigator Award (CA-28526) from the National Cancer Institute. To whom requests for reprints should be addressed, at Department of Laboratory Medicine and Pathology, Box 609 Mayo, University of Minnesota, Minneapolis, Minn. 55455.