Guglielmi P, Preud'homme J L, Ciorbaru-Barot R, Seligmann M
J Clin Immunol. 1982 Jul;2(3):186-96. doi: 10.1007/BF00915221.
Peripheral blood lymphocytes from eight patients with untreated B-derived chronic lymphocytic leukemia (CLL) (only one had a serum monoclonal immunoglobulin) were stimulated by Nocardia, phytohemagglutinin, and pokeweed mitogen. This stimulation resulted in the occurrence in all but one case of large cytoplasmic immunoglobulin-containing cells with a predominantly lymphoblastic (six cases) or plasmacytic (one case) appearance. These blast cells contained the same immunoglobulin chains as those of the surface immunoglobulins on fresh lymphocytes except for delta chains that were not found by cytoplasmic immunofluorescence. In three cases, intracytoplasmic immunoglobulin inclusions that were present in both small lymphocytes and stimulated blast cells provided further evidence of the differentiation of the leukemic clone. In another case, both small leukemic B lymphocytes and large B blast cells expressed in vitro a receptor for sheep erythrocytes. A switch from IgM to IgG synthesis was observed in this patients, whose cells showed the strongest response to the activators. The most effective activator was Nocardia, then phytohemagglutinin, whereas an effect of pokeweed mitogen was observed only when the fresh lymphocytes contained a fair percentage of T cells. Leukemic cells, in most patients, were able to differentiate without appreciable B-cell proliferation.
来自8例未经治疗的B细胞慢性淋巴细胞白血病（CLL）患者（仅1例有血清单克隆免疫球蛋白）的外周血淋巴细胞，用诺卡氏菌、植物血凝素和商陆有丝分裂原进行刺激。这种刺激导致除1例之外的所有病例均出现了大的含细胞质免疫球蛋白的细胞，其外观主要为淋巴母细胞样（6例）或浆细胞样（1例）。这些母细胞所含的免疫球蛋白链与新鲜淋巴细胞表面免疫球蛋白的链相同，但通过细胞质免疫荧光未发现δ链。在3例中，小淋巴细胞和受刺激的母细胞中均存在的胞质内免疫球蛋白包涵体，为白血病克隆的分化提供了进一步证据。在另一例中，白血病小B淋巴细胞和大B母细胞在体外均表达了绵羊红细胞受体。在该对激活剂反应最强的患者中，观察到了从IgM合成向IgG合成的转换。最有效的激活剂是诺卡氏菌，其次是植物血凝素，而仅当新鲜淋巴细胞含有相当比例的T细胞时，才观察到商陆有丝分裂原的作用。在大多数患者中，白血病细胞能够分化，而无明显的B细胞增殖。
