Vardiman J W, Gilewski T A, Ratain M J, Bitter M A, Bradlow B A, Golomb H M
Department of Pathology, University of Chicago Pritzker School of Medicine, Illinois.
Am J Clin Pathol. 1988 Sep;90(3):250-6. doi: 10.1093/ajcp/90.3.250.
The concomitant presence of B antigens and of the antigen recognized by the monoclonal antibody Leu-M5 (CD11c) on neoplastic lymphoid cells has been reported to be largely restricted to hairy cell leukemia (HCL). The authors studied Leu-M5 reactivity of neoplastic cells from 59 patients whose specimens were referred with a stated diagnosis of HCL by using the alkaline phosphatase anti-alkaline phosphatase technique on peripheral blood (PB) and bone marrow (BM) specimens. Tartrate-resistant acid phosphatase (AcP-T) activity was also studied. In 49 patients, HCL had been confirmed previously by BM biopsy, and specimens were evaluated for disease status during or after therapy with interferon (IFN) or 2'-deoxycoformycin. The remaining ten patients were newly referred for confirmation of the diagnosis of HCL before therapy. In all 55 patients in whom the BM biopsy demonstrated HCL, virtually every leukemic cell was Leu-M5 reactive, and the reaction proved, in some cases, to be helpful in the detection of small numbers of hairy cells in PB or BM preparations. AcP-T reactivity was demonstrated in the neoplastic cells of 52 of these 55 patients, including all but 3 of those receiving IFN, and was helpful in confirming persistent leukemia when interpretation of BM biopsy sections was difficult because the numbers of hairy cells were small. However, in four of the ten newly referred patients, BM biopsy showed features of splenic lymphoma with villous lymphocytes, rather than HCL. The neoplastic cells of these four patients were of B-cell origin and in three were Leu-M5 reactive. The authors' study indicates that Leu-M5 is present in nearly all hairy cells, but its presence in conjunction with other B-cell markers is not specific for HCL.
据报道，肿瘤性淋巴细胞上B抗原与单克隆抗体Leu - M5（CD11c）识别的抗原同时存在的情况在很大程度上仅限于毛细胞白血病（HCL）。作者运用碱性磷酸酶抗碱性磷酸酶技术，对59例标本被确诊为HCL的患者外周血（PB）和骨髓（BM）标本中的肿瘤细胞进行了Leu - M5反应性研究。同时也研究了耐酒石酸酸性磷酸酶（AcP - T）活性。49例患者之前已通过骨髓活检确诊为HCL，对这些患者在接受干扰素（IFN）或2'-脱氧助间型霉素治疗期间或之后的标本进行疾病状态评估。其余10例患者为新转诊，在治疗前确诊HCL。在所有55例骨髓活检显示为HCL的患者中，几乎每个白血病细胞都是Leu - M5反应性的，并且在某些情况下，该反应有助于检测PB或BM制剂中的少量毛细胞。这55例患者中有52例的肿瘤细胞显示AcP - T反应性，其中包括除3例接受IFN治疗的患者外的所有患者，当由于毛细胞数量少而难以解读骨髓活检切片时，AcP - T反应性有助于确认持续性白血病。然而，在10例新转诊患者中有4例，骨髓活检显示为脾淋巴瘤伴绒毛状淋巴细胞的特征，而非HCL。这4例患者的肿瘤细胞起源于B细胞，其中3例为Leu - M5反应性。作者的研究表明，Leu - M5几乎存在于所有毛细胞中，但它与其他B细胞标志物同时存在并非HCL所特有。
