Pilarski L M, Mant M J, Ruether B A, Belch A
J Clin Invest. 1984 Oct;74(4):1301-6. doi: 10.1172/JCI111540.
A major problem in the assessment of circulating B lymphocytes in multiple myeloma is the extent to which cells with passively absorbed Ig contribute to the assay. We have analyzed peripheral blood B cell numbers in 51 patients in various treatment categories by using an assay that is not subject to artifacts involving cytophilic Ig. We have defined a B lymphocyte by three different criteria (a) expression of a high surface density of Ig (b) expression of a high density of HLA.DR and (c) expression of a marker exclusive to surface Ig+ B cells. By these criteria, normal individuals have an average of 6% B cells. In multiple myeloma patients, B cell levels in purified mononuclear cell preparations are severely reduced. Untreated patients and the majority of patients on intermittent chemotherapy have 20-600-fold fewer B cells than do normal donors (average = 0.3%). This decrease was even greater in whole blood of patients as compared with normal donors (100-1,000-fold fewer B cells). The number of B cells did not correlate with disease status or paraprotein concentration. We found no evidence to support the idea that B lymphocytes in patients include a substantial monoclonal subset.
评估多发性骨髓瘤中循环B淋巴细胞的一个主要问题是，被动吸附免疫球蛋白（Ig）的细胞对检测结果的影响程度。我们采用了一种不受嗜细胞性Ig相关假象影响的检测方法，分析了51例处于不同治疗阶段的患者外周血B细胞数量。我们通过三种不同标准定义B淋巴细胞：（a）高表面密度Ig的表达；（b）高密度HLA-DR的表达；（c）表面Ig+B细胞特有的标志物的表达。按照这些标准，正常个体平均有6%的B细胞。在多发性骨髓瘤患者中，纯化单核细胞制剂中的B细胞水平严重降低。未经治疗的患者以及大多数接受间歇化疗的患者，其B细胞数量比正常供体少20 - 600倍（平均 = 0.3%）。与正常供体相比，患者全血中的B细胞减少更为明显（少100 - 1000倍）。B细胞数量与疾病状态或副蛋白浓度无关。我们没有发现证据支持患者体内的B淋巴细胞包含大量单克隆亚群这一观点。
