Surface immunoglobulins in lymphocytic leukemias.
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Biomedical subjects
Publications and source records attributed to J L Binet.
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Forty-three patients with a lymphoid hemopathy, three with agammaglobulinemia and six normal controls were investigated with regard to their blood lymphocyte membrane-associated light chains. Detection and quantitation of antigenic determinants were performed by means of peroxidase-labeled antibodies. Compared to normal controls, values found in chronic lymphocytic leukemia (CLL) were very low (tenfold decrease). The number of antigenic determinants on lymphoid cells from patients with blast crises supervening in CLL, prolymphocytic leukemia, Waldenström's macroglobulinemia and Burkitt-cell acute leukemia were significantly higher than those seen in patients with CLL. The data obtained in this investigation through quantitative immunocytology constitutes a new parameter for the classification of lymphoid hemopathies and for an approach to their pathogenesis, in particular if the quantity of membrane immunoglobulin correlates with the stage of cell maturation.
The peripheral lymphocyte count and the number of large unstained cells (LUC) were investigated prior to and 4 hr after a single intravenous injection of 400 mg of hydrocortisone in 23 controls and 51 patients with lymphoid disorders (43 chronic lymphocytic leukemia, 3 cases of Waldenström macroglobulinemia, 2 hairy cell leukemias, 1 Sézary syndrome, and 2 cases of infectious mononucleosis). A reduction in both the peripheral lymphocyte counts and the number of LUC was observed in all normal controls, the mean decrease being 54% and greater than 60%, respectively, with differences according to age. In chronic lymphocytic leukemia (CLL), the peripheral lymphocyte count showed a variable response: decrease, no change, or increase. A correlation was shown to exist between a decrease in peripheral lymphocyte counts and anatomical-clinical staging: patients with involvement restricted to blood and bone marrow very often exhibited a drop in their peripheral lymphocyte count (p less than 0.01). In addition, the percentage of circulating T lymphocytes was higher (54%) in CLL patients whose peripheral lymphocyte count dropped than in other CLL patients (p less than 0.001).
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Sixty-seven lymphangiograms were performed in 58 patients with chronic lymphocytic leukemia. These patients were classified according to a new anatomico-clinical staging system which has previously been shown to bear prognostic significance. The lymphangiograms were divided into four groups on the basis of lymph node size and each group was further divided into subgroups (12). Each subgroup corresponded to a different roentgenographic picture. A good correlation was observed between lymphangiographic and anatomico-clinical staging: lymphangiogram groups 3 and 4, anatomico-clinical stage III and IV (p less than 0.001). The absence of normal lymph nodes in all patients, the diversity of lymphangiographic appearance from one patient to another and even the diversity from one region to another in the same patient should be stressed.
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Five cases of atypical lymphocytic leukemia were investigated with regard to their membrane-associated light chains. Detection and quantitation of antigenic determinants were performed by means of peroxidase-labeled antibodies according to Avrameas et al. The cases studied had clinical and cytologic features in common: an active clinical course, marked splenomegaly, severe anemia and thrombocytopenia, little or no lymph node enlargement, and very high white blood counts with small mature lymphocytes and poorly differentiated lymphoid cells. Blood lymphocytes of all patients carried a single type of light chain, and 90%-100% of the cells were stained. The average number of antigenic sites per cell was 72,500 (range 40,000-97,500). These results differed from those previously found in typical CLL (mean value 9000) and approached the values of normal peripheral blood lymphocytes (90,000). The criteria investigated in this study could be of value for the diagnosis and prognosis of some atypical forms of lymphocytic leukemia.
Some vegetable extract have haemagglutinating activity and are able to transform lymphocytes in culture. The comparative activities of lectin from Pisum sativum and other lectins already used (phytohaere shown. This lectin can be isolated in a highly purified form which is described. Purification of the human blood lymphocytes is obtained through nylon columns and measurement of transformation and proliferation by means of 3 H thymidine incorporation. Normal lymphocyte stimulation can be obtained within a range of concentrations of stimulants can be obtained within a range of concentrations of stimulants and the curves with PHA or lectin from Pisum show a peak of blastogenic activity. The activity of lectin from Pisum sativum was studied in this way on blood cultures of 8 chronic lymphocytic leukaemias and 5 immunodeficient patients. It appeared that lectin from Pisum and PHA have the same activity. The response of human peripheral lymphocytes to various mitogenic agents in vitro does not point out the proliferative abnormal cell and may not be used to detect different populations of human lymphocytes.
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