Laboratory, morphologic, and immunophenotypic correlates of surface immunoglobulin heavy chain isotype expression in B-cell chronic lymphocytic leukemia

• Published in: American journal of clinical pathology 2001-12, Vol.116 (6), p.905-912
• Main Authors: SHEN, Peter U. F, FULLER, Sheila G, REZUKE, William N, SHERBURNE, Bradford J, DIGIUSEPPE, Joseph A
• Format: Article
• Language: English
• Subjects: ADP-ribosyl Cyclase; ADP-ribosyl Cyclase 1; Antigens, CD; Antigens, Differentiation - metabolism; B-Lymphocytes - metabolism; B-Lymphocytes - pathology; Biological and medical sciences; Flow Cytometry; Hematologic and hematopoietic diseases; Humans; Immunoglobulin D - analysis; Immunoglobulin Heavy Chains - metabolism; Immunoglobulin Isotypes - metabolism; Immunoglobulin M - analysis; Immunophenotyping; Leukemia, Lymphocytic, Chronic, B-Cell - immunology; Leukemia, Lymphocytic, Chronic, B-Cell - metabolism; Leukemia, Lymphocytic, Chronic, B-Cell - pathology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Leukocyte Count; Medical sciences; Membrane Glycoproteins; NAD+ Nucleosidase - metabolism; Receptors, Antigen, B-Cell - metabolism
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/1TYF-VPM9-CQ2C-B0TF

We compared surface immunoglobulin heavy chain isotype expression with a number of laboratory, morphologic, and immunophenotypic features in a series of 76 cases of B-cell chronic lymphocytic leukemia (B-CLL). Fifty-five cases were IgM+/IgD+, a phenotype associated with antigenically naïve B cells; 16 cases expressed IgD without IgM, a phenotype seen in a subset of normal B cells with extensive somatic immunoglobulin variable region (IgV) gene mutations; and 5 cases were IgD-, a phenotype associated with memory B cells. WBC count, atypical morphologic features, atypical immunophenotypic characteristics, and CD38 expression were nonrandomly distributed among the 3 categories of heavy chain isotype expression. Moreover, a WBC count more than 30,000/microL (30 x 10(9)/L), atypical morphologic features, and CD38 expression in more than 30% of neoplastic cells (all adverse prognostic factors in B-CLL) were less common among IgD-only cases than among IgM+/IgD+ and IgD- cases. These data demonstrate that surface immunoglobulin heavy chain isotype expression is associated with several laboratory, morphologic, and immunophenotypic features in B-CLL. The subset of B-CLL with the IgD-only phenotype is associated with several favorable prognostic factors, suggesting the possibility that IgD-only B-CLL may be associated with a favorable prognosis.