Hurwitz C A, Loken M R, Graham M L, Karp J E, Borowitz M J, Pullen D J, Civin C I
Johns Hopkins Oncology Center, Pediatric Oncology, Baltimore, MD 21205.
Blood. 1988 Jul;72(1):299-307.
Cell surface phenotypes of 113 B lineage acute lymphocytic leukemia (ALL) cases, defined by the presence of HLA-DR and at least one B-cell-specific antigen (either CD19, CD20, or CD22), were compared with antigen-defined stages of normal B lymphocyte development. The cases were first evaluated for expression of HLA-DR, CD19, CD34, CD10, CD20, and CD22 by indirect one-color immunofluorescence. Pairwise comparisons of cell surface marker expression were performed for each leukemic sample: no correlations were observed for paired antigen expression on the leukemic samples using antigens expressed either early or late during normal B lymphoid development. Complete immunophenotypes of the cases were then compared with normal B-cell developmental stages. Sixteen different complete immunophenotypes were observed on the leukemias that were not found in normal marrow; at least 78% of the cases demonstrated such "asynchronous" combinations of B lymphoid-associated differentiation antigens. Several samples were subsequently studied by two-color immunofluorescence, and the presence of doubly labeled cells with "asynchronous" antigen combinations was confirmed. These results indicate that the majority of B lineage leukemias exhibit "developmental asynchrony," as compared with normal marrow B cells. The data further suggest that ALL cases do not accurately represent cells arrested at the stage where the leukemogenic event occurred. Rather, ALL appears to be a disease in which there may be maturation of leukemic blasts; but this maturation is "asynchronous" when compared with the normal developmental process.
通过HLA - DR和至少一种B细胞特异性抗原（CD19、CD20或CD22）的存在来定义的113例B系急性淋巴细胞白血病（ALL）病例的细胞表面表型，与正常B淋巴细胞发育的抗原定义阶段进行了比较。首先通过间接单色免疫荧光对这些病例进行HLA - DR、CD19、CD34、CD10、CD20和CD22表达的评估。对每个白血病样本进行细胞表面标志物表达的成对比较：在正常B淋巴细胞发育早期或晚期表达的抗原，在白血病样本上的成对抗原表达未观察到相关性。然后将病例的完整免疫表型与正常B细胞发育阶段进行比较。在白血病上观察到16种不同的完整免疫表型，这些表型在正常骨髓中未发现；至少78%的病例表现出这种B淋巴细胞相关分化抗原的“异步”组合。随后通过双色免疫荧光对几个样本进行研究，证实了具有“异步”抗原组合的双标记细胞的存在。这些结果表明，与正常骨髓B细胞相比，大多数B系白血病表现出“发育异步”。数据进一步表明，ALL病例不能准确代表在白血病发生事件阶段停滞的细胞。相反，ALL似乎是一种白血病母细胞可能成熟的疾病；但与正常发育过程相比，这种成熟是“异步”的。
