Antibodies against urinary light chain idiotypes as agents for detection and destruction of human neoplastic B lymphocytes.

Patients with B cell neoplasms frequently have low levels of tumor-related light chains in their urine; these light chains can be isolated with the use of relatively simple methods and then used to raise antibodies to the idiotypic determinants. In this study, anti-light chain idiotypes were raised against monoclonal light chains from the urine of four patients with chronic lymphocytic leukemia. The antibodies reacted specifically with the tumor cells of the homologous patient, assessed by immunofluorescence, and can therefore be used for tumor cell detection. In one case for which serum idiotypic IgM was available, the anti-light chain idiotype was shown to bind whole idiotypic IgM, and such binding could be inhibited by idiotypic IgM or idiotypic light chains, which demonstrates recognition of similar antigenic determinants. The binding of antibody to tumor cells was also totally inhibited by idiotypic IgM. The analysis of separated sera from the four patients for free light chains demonstrated only low levels (3.0 to 8.6 micrograms/ml of serum with a mean of 5.8), which suggests that light chain is rapidly cleared and therefore does not present a major barrier to antibody attack. It should be feasible to use such antibodies for both analysis and therapy of B cell neoplasms.