Konwalinka G, Schirmer M, Hilbe W, Fend F, Geisen F, Knoblechner A, Petzer A, Thaler J
Department of Internal Medicine, University Hospital, Innsbruck, Austria.
Blood Cells Mol Dis. 1995;21(2):142-51. doi: 10.1006/bcmd.1995.0016.
Some patients in apparent complete remission of hairy cell leukemia (HCL) after 2-chlorodeoxyadenosine (2-CdA) treatment may have minimal residual disease (MRD). This study examines detection of minimal residual disease by immunohistological staining using the monoclonal antibody (MoAb) B-ly 7 in 11 patients with complete remission of hairy cell leukemia (HCL) after 2-CdA therapy administered between 1990 and 1993. In all 11 cases, residual hairy cells could be detected by MoAb B-ly 7 (0.1 to 7.5%, median 0.65%). At a follow-up period of 7 - 29 months (median 19.3), 9 of these patients remained in complete remission, whereas 2 patients relapsed 22 and 27 months after 2-CdA therapy. To determine whether flow-cytometric analysis of hairy-cells in bone marrow aspirates and peripheral blood cells are comparable with results obtained by immunostaining with B-ly 7 in bone marrow biopsies, available data using CD-19/CD-11c double-staining were analyzed. In 5 of 10 cases no hairy-cells could be detected in bone marrow aspirates, and in 6 partly different cases no hairy-cells were detectable in peripheral blood using flow-cytometry, although immunostaining of bone marrow biopsies using B-ly 7 revealed hairy-cells (ranging form 0.1 to 7.5%) in these cases. These results indicate that therapy with 2-CdA does not eradicate hairy cell leukemia despite complete remission according to conventional criteria. Minimal residual disease might be responsible for subsequent relapse. We conclude that routine immunohistological examination of bone marrow biopsies with B-ly 7 should be performed for assessment of MRD. Flow cytometric investigations of mononuclear cells of bone marrow aspirate or peripheral blood seem valuable for regular long term monitoring of MRD, but does not substitute for immunostaining of bone marrow biopsies.
部分毛细胞白血病（HCL）患者在接受2-氯脱氧腺苷（2-CdA）治疗后看似完全缓解，但可能仍存在微小残留病（MRD）。本研究采用单克隆抗体（MoAb）B-ly 7对1990年至1993年间接受2-CdA治疗后处于完全缓解期的11例毛细胞白血病（HCL）患者进行免疫组织化学染色，检测微小残留病。在所有11例病例中，均可通过MoAb B-ly 7检测到残留的毛细胞（0.1%至7.5%，中位数为0.65%）。在7至29个月（中位数为19.3个月）的随访期内，其中9例患者仍处于完全缓解状态，而2例患者在2-CdA治疗后22个月和27个月复发。为了确定骨髓穿刺液和外周血细胞中毛细胞的流式细胞术分析结果与骨髓活检中B-ly 7免疫染色结果是否具有可比性，对使用CD-19/CD-11c双重染色的现有数据进行了分析。在10例病例中的5例中，骨髓穿刺液中未检测到毛细胞，在6例部分不同的病例中，使用流式细胞术在外周血中未检测到毛细胞，尽管这些病例中骨髓活检的B-ly 7免疫染色显示存在毛细胞（范围为0.1%至7.5%）。这些结果表明，尽管根据传统标准已完全缓解，但2-CdA治疗并不能根除毛细胞白血病。微小残留病可能是随后复发的原因。我们得出结论，应使用B-ly 7对骨髓活检进行常规免疫组织学检查以评估MRD。对骨髓穿刺液或外周血单个核细胞进行流式细胞术检测对于MRD的定期长期监测似乎有价值，但不能替代骨髓活检的免疫染色。
