Abstract
A patient is described who presented with a disease clinically resembling chronic lymphocytic leukaemia, characterized by generalized lymphadenopathy, pleural and peritoneal effusions, a blood lymphocyte count of 700,000/mul and failure to respond to conventional therapy. At least 95% of these cells formed rosettes with sheep erythrocytes (E) and with erythrocytes coated with 19S antibodies and complement (EAC). All of these cells bound rabbit anti-human thymocyte serum; this serum bound to 0--22% of the lymphocytes from twenty other patients with chronic lymphocytic leukaemia. These unusual cells did not bear surface immunoglobulin detectable by immunofluorescence. The clinical and cellular features of this malignancy are compared to previously reported cases of T cell chronic lymphocytic leukaemia. As this case illustrates, T-cell chronic lymphocytic leukaemia may present without skin lesions and may be a more aggressive disease than the more common B-cell neoplasm.
Full text
PDF










Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aisenberg A. C., Bloch K. J., Long J. C. Cell-surface immunoglobulins in chronic lymphocytic leukemia and allied disorders. Am J Med. 1973 Aug;55(2):184–191. doi: 10.1016/0002-9343(73)90167-8. [DOI] [PubMed] [Google Scholar]
- Aisenberg A. C., Bloch K. J., Long J. C., Colvin R. B. Reaction of normal human lymphocytes and chronic lymphocytic leukemia cells with an antithymocyte antiserum. Blood. 1973 Mar;41(3):417–423. [PubMed] [Google Scholar]
- Bentwich Z., Douglas S. D., Siegal F. P., Kunkel H. G. Human lymphocyte-sheep erythrocyte rosette formation: some characteristics of the interaction. Clin Immunol Immunopathol. 1973 Jul;1(4):511–522. doi: 10.1016/0090-1229(73)90007-x. [DOI] [PubMed] [Google Scholar]
- Bollum F. J. Antibody to terminal deoxynucleotidyl transferase. Proc Natl Acad Sci U S A. 1975 Oct;72(10):4119–4122. doi: 10.1073/pnas.72.10.4119. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brouet J. C., Sasportes M., Flandrin G., Preud'Homme J. L., Seligmann M. Chronic lymphocytic leukaemia of T-cell origin. Immunological and clinical evaluation in eleven patients. Lancet. 1975 Nov 8;2(7941):890–893. doi: 10.1016/s0140-6736(75)92127-3. [DOI] [PubMed] [Google Scholar]
- Brown G., Greaves M. F., Lister T. A., Rapson N., Papamichael M. Expression of human T and B lymphocyte cell-surface markers on leukaemic cells. Lancet. 1974 Sep 28;2(7883):753–755. doi: 10.1016/s0140-6736(74)90945-3. [DOI] [PubMed] [Google Scholar]
- Catovsky D., Galetto J., Okos A., Galton D. A., Wiltshaw E., Stathopoulos G. Prolymphocytic leukaemia of B and T cell type. Lancet. 1973 Aug 4;2(7823):232–234. doi: 10.1016/s0140-6736(73)93135-8. [DOI] [PubMed] [Google Scholar]
- Catovsky D., Miliani E., Okos A., Galton D. A. Clinical significance of T-cells in chronic lymphocytic leukaemia. Lancet. 1974 Sep 28;2(7883):751–752. doi: 10.1016/s0140-6736(74)90944-1. [DOI] [PubMed] [Google Scholar]
- Cebra J. J., Goldstein G. Chromatographic purification of tetramethylrhodamine-immune globulin conjugates and their use in the cellular localization of rabbit gamma-globulin polypeptide chains. J Immunol. 1965 Aug;95(2):230–245. [PubMed] [Google Scholar]
- Chiao J. W., Pantic V. S., Good R. A. Human lymphocytes bearing both receptors for complement components and SRBC. Clin Immunol Immunopathol. 1975 Nov;4(4):545–556. doi: 10.1016/0090-1229(75)90096-3. [DOI] [PubMed] [Google Scholar]
- Chin A. H., Saiki J. H., Trujillo J. M., Williams R. C., Jr Peripheral blood T- and B-lymphocytes in patients with lymphoma and acute leukemia. Clin Immunol Immunopathol. 1973 Jul;1(4):499–510. doi: 10.1016/0090-1229(73)90006-8. [DOI] [PubMed] [Google Scholar]
- Dickler H. B., Adkinson N. F., Jr, Terry W. D. Evidence for individual human peripheral blood lymphocytes bearing both B and T cell markers. Nature. 1974 Jan 25;247(5438):213–215. doi: 10.1038/247213a0. [DOI] [PubMed] [Google Scholar]
- Dickler H. B., Kunkel H. G. Interaction of aggregated -globulin with B lymphocytes. J Exp Med. 1972 Jul 1;136(1):191–196. doi: 10.1084/jem.136.1.191. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dickler H. B., Siegal F. P., Bentwich Z. H., Kunkel H. G. Lymphocyte binding of aggregated IgG and surface Ig staining in chronic lymphocytic leukaemia. Clin Exp Immunol. 1973 May;14(1):97–106. [PMC free article] [PubMed] [Google Scholar]
- Edelson R. L., Kirkpatrick C. H., Shevach E. M., Schein P. S., Smith R. W., Green I., Lutzner M. Preferential cutaneous infiltration by neoplastic thymus-derived lymphocytes. Morphologic and functional studies. Ann Intern Med. 1974 Jun;80(6):685–692. doi: 10.7326/0003-4819-80-6-685. [DOI] [PubMed] [Google Scholar]
- Ehlenberger A. G., McWilliams M., Phillips-Quagliata J. M., Lamm M. E., Nussenzweig V. Immunoglobulin-bearing and complement-receptor lymphocytes constitute the same population in human peripheral blood. J Clin Invest. 1976 Jan;57(1):53–56. doi: 10.1172/JCI108268. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Grey H. M., Rabellino E., Pirofsky B. Immunoglobulins on the surface of lymphocytes. IV. Distribution in hypogammaglobulinemia, cellular immune deficiency, and chronic lymphatic leukemia. J Clin Invest. 1971 Nov;50(11):2368–2375. doi: 10.1172/JCI106735. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hsu C. C., Marti G. E., Schrek R., Williams R. C., Jr Lymphocytes bearing B- and T-cell markers in patient with lymphosarcoma cell leukemia. Clin Immunol Immunopathol. 1975 Jan;3(3):385–395. doi: 10.1016/0090-1229(75)90026-4. [DOI] [PubMed] [Google Scholar]
- Jondal M., Holm G., Wigzell H. Surface markers on human T and B lymphocytes. I. A large population of lymphocytes forming nonimmune rosettes with sheep red blood cells. J Exp Med. 1972 Aug 1;136(2):207–215. doi: 10.1084/jem.136.2.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kamihira S., Kinosita K., Nagiri A., Nonaka M. [Surface nature of B and T cell in chronic lymphocytic leukemia (author's transl)]. Rinsho Ketsueki. 1974 Nov;15(11):1203–1211. [PubMed] [Google Scholar]
- Lille I., Desplaces A., Meeus L., Saracino R. T., Brouet J. C. Thymus-derived proliferating lymphocytes in chronic lymphocytic leukaemia. Lancet. 1973 Aug 4;2(7823):263–264. doi: 10.1016/s0140-6736(73)93170-x. [DOI] [PubMed] [Google Scholar]
- Lutzner M. A., Jordan H. W. The ultrastructure of an abnormal cell in Sézary's syndrome. Blood. 1968 Jun;31(6):719–726. [PubMed] [Google Scholar]
- McCaffrey R., Harrison T. A., Parkman R., Baltimore D. Terminal deoxynucleotidyl transferase activity in human leukemic cells and in normal human thymocytes. N Engl J Med. 1975 Apr 10;292(15):775–780. doi: 10.1056/NEJM197504102921504. [DOI] [PubMed] [Google Scholar]
- Mendes N. F., Miki S. S., Peixinho Z. F. Combined detection of human T and B lymphocytes by rosette formation with sheep erythrocytes and zymosan-C3 complexes. J Immunol. 1974 Aug;113(2):531–536. [PubMed] [Google Scholar]
- Peterson L. C., Bloomfield C. D., Sundberg R. D., Gajl-Peczalska K. J., Brunning R. D. Morphology of chronic lymphocytic leukemia and its relationship to survival. Am J Med. 1975 Sep;59(3):316–324. doi: 10.1016/0002-9343(75)90389-7. [DOI] [PubMed] [Google Scholar]
- Piessens W. F., Schur P. H., Moloney W. C., Churchill W. H. Lymphocyte surface immunoglobulins. Distribution and frequency in lymphoproliferative diseases. N Engl J Med. 1973 Jan 25;288(4):176–180. doi: 10.1056/NEJM197301252880403. [DOI] [PubMed] [Google Scholar]
- Pincus S., Bianco C., Nussenzweig V. Increased proportion of complement-receptor lymphocytes in the peripheral blood of patients with chronic lymphocytic leukemia. Blood. 1972 Sep;40(3):303–310. [PubMed] [Google Scholar]
- Preud'homme J. L., Seligmann M. Surface bound immunoglobulins as a cell marker in human lymphoproliferative diseases. Blood. 1972 Dec;40(6):777–794. [PubMed] [Google Scholar]
- Rejnek J., Mage R. G., Reisfeld R. A. Rabbit light chains lacking b-allotypic specificites. I. Isolation and characterization of light chains from normal and allotype suppressed homozygotes. J Immunol. 1969 Mar;102(3):638–646. [PubMed] [Google Scholar]
- Ross G. D., Rabellino E. M., Polley M. J., Grey H. M. Combined studies of complement receptor and surface immunoglobulin-bearing cells and sheep erythrocyte rosette-forming cells in normal and leukemic human lymphocytes. J Clin Invest. 1973 Feb;52(2):377–385. doi: 10.1172/JCI107194. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rowlands D. T., Jr, Daniele R. P., Nowell P. C., Wurzel H. A. Characterization of lymphocyte subpopulations in chronic lymphocytic leukemia. Cancer. 1974 Dec;34(6):1962–1970. doi: 10.1002/1097-0142(197412)34:6<1962::aid-cncr2820340615>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
- Rudders R. A. B lymphocyte subpopulations in chronic lymphocytic leukemia. Blood. 1976 Feb;47(2):229–235. [PubMed] [Google Scholar]
- Sandilands G. P., Gray K., Cooney A., Browning J. D., Grant R. M., Anderson J. R., Dagg J. H., Lucie N. Lymphocytes with T and B cell properties in a lymphoproliferative disorder. Lancet. 1974 May 11;1(7863):903–904. doi: 10.1016/s0140-6736(74)90350-x. [DOI] [PubMed] [Google Scholar]
- Sarin P. S., Anderson P. N., Gallo R. C. Terminal deoxynucleotidyl transferase activities in human blood leukocytes and lymphoblast cell lines: high levels in lymphoblast cell lines and in blast cells of some patients with chronic myelogenous leukemia in acute phase. Blood. 1976 Jan;47(1):11–20. [PubMed] [Google Scholar]
- Shevach E. M., Herberman R., Frank M. M., Green I. Receptors for complement and immunoglobulin on human leukemic cells and human lymphoblastoid cell lines. J Clin Invest. 1972 Aug;51(8):1933–1938. doi: 10.1172/JCI106999. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shevach E., Edelson R., Frank M., Lutzner M., Green I. A human leukemia cell with both B and T cell surface receptors. Proc Natl Acad Sci U S A. 1974 Mar;71(3):863–866. doi: 10.1073/pnas.71.3.863. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Siegal F. P., Voss R., Al-Mondhiry H., Polliack A., Hansen J. A., Siegal M., Good R. A. Association of a chromosomal abnormality with lymphocytes having both T and B markers in a patient with lymphoproliferative disease. Am J Med. 1976 Jan;60(1):157–166. doi: 10.1016/0002-9343(76)90545-3. [DOI] [PubMed] [Google Scholar]
- Smith J. L., Haegert D. B- and T-lymphocyte markers on transformed lymphocytes from mitogen-stimulated cultures of normal and CLL lymphocytes and on tonsil blasts. Clin Exp Immunol. 1974 Aug;17(4):547–560. [PMC free article] [PubMed] [Google Scholar]
- Sumiya M., Mizoguchi H., Kosaka K., Miura Y., Takaku F., Yato J. I. Letter: Chronic lymphocytic leukaemia of T-cell origin? Lancet. 1973 Oct 20;2(7834):910–910. doi: 10.1016/s0140-6736(73)92040-0. [DOI] [PubMed] [Google Scholar]
- Thiel E., Rodt H., Huhn D., Thierfelder S. Decrease and altered distribution of human T antigen on chronic lymphatic leukemia cells of T type, suggesting a clonal origin. Blood. 1976 May;47(5):723–736. [PubMed] [Google Scholar]
- Tsukimoto I., Wong K. Y., Lampkin B. C. Surface markers and prognostic factors in acute lymphoblastic leukemia. N Engl J Med. 1976 Jan 29;294(5):245–248. doi: 10.1056/NEJM197601292940503. [DOI] [PubMed] [Google Scholar]
- Williams R. C., Jr, DeBoard J. R., Mellbye O. J., Messner R. P., Lindström F. D. Studies of T- and B-lymphocytes in patients with connective tissue diseases. J Clin Invest. 1973 Feb;52(2):283–295. doi: 10.1172/JCI107184. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Winkelmann R. K. Clinical studies of T-cell erythroderma in the Sezary syndrome. Mayo Clin Proc. 1974 Aug;49(8):519–525. [PubMed] [Google Scholar]
- Winkelmann R. K., Linman J. W. Erythroderma with atypical lymphocytes. (Sézary syndrome). Am J Med. 1973 Aug;55(2):192–198. doi: 10.1016/0002-9343(73)90168-x. [DOI] [PubMed] [Google Scholar]
- Wood B. T., Thompson S. H., Goldstein G. Fluorescent antibody staining. 3. Preparation of fluorescein-isothiocyanate-labeled antibodies. J Immunol. 1965 Aug;95(2):225–229. [PubMed] [Google Scholar]
- Wybran J., Chantler S., Fudenberg H. H. Isolation of normal T cells in chronic lymphatic leukaemia. Lancet. 1973 Jan 20;1(7795):126–129. doi: 10.1016/s0140-6736(73)90196-7. [DOI] [PubMed] [Google Scholar]
- Yodoi J., Takatsuki K., Masuda T. Letter: Two cases of T-cell chronic lymphocytic leukemia in Japan. N Engl J Med. 1974 Mar 7;290(10):572–573. doi: 10.1056/NEJM197403072901018. [DOI] [PubMed] [Google Scholar]


