Establishment and characterization of a B-cell line from a patient with acute lymphoblastic leukemia

A permanent lymphoblastoid cell line was established from the peripheral blood of a child with acute lymphoblastic leukemia. The cell line, designated SDK, grows in a stationary suspension culture, forming aggregates, in RPMI medium supplemented with 10% FCS, with a doubling time of 50-60 h. Immunologic markers and cytological features suggested that the SDK cells should be identified as being of B-cell origin. The cells failed to form rosettes with sheep erythrocytes, did not express T-cell antigens as defined by monoclonal antibodies, and exhibited surface and cytoplasmic immunoglobulin determinants. Chromosome analysis revealed the presence of three cell populations with (a) 46XY; (b) t(8q-; 14q+) or 2p-; 14q+) and (c) cells with unidentifiable markers. SDK demonstrated susceptibility to TPA-induced differentiation toward plasma cells.     

Occurrence of immunoblastic B-cell lymphoma in hairy cell leukemia

A 47-year-old man, was referred for evaluation of asymptomatic splenomegaly in September 1981, and a diagnosis of hairy cell leukemia (HCL) at the initial clinical stage was made. The patient remained asymptomatic until May 1985, when splenectomy was performed because of anemia and splenomegaly. Bone marrow and liver biopsy specimens showed diffuse infiltration by abnormal tartase resistant acid phosphatase (TRAP) positive lymphocytes with typical aspect of hairy cells. Four months later, he developed fever of unknown origin and, at laparotomy, diffuse retroperitoneal lymph node enlargement and metastatic liver nodules were seen. Lymph node and liver biopsy specimens showed diffuse infiltration by abnormal large lymphocytes, which bore monoclonal surface immunoglobulin M and light chain kappa. Only six cases of non-Hodgkin's lymphoma associated with HCL have been published to date. This report describes an additional case of immunoblastic B-cell lymphoma, preceded 4 years earlier by the diagnosis of HCL.     

Establishment and characterization of an Epstein-Barr virus spontaneously transformed lymphocytic cell line derived from a hairy cell leukemia patient.

Hairy cell leukemia is a rare, B-cell malignancy uniquely sensitive to the antitumor effects of alpha and beta interferons (IFN). In order to further study the effects of IFN in this disease, we derived a cell line (HC1) from the peripheral blood mononuclear cells of a patient with hairy cell leukemia (HCL). Cells exhibited the typical morphological features of HCL, including the characteristic cytoplasmic projections by light, transmission, and scanning electron microscopy. HC1 cells were of B-cell lineage, as evidenced by immunophenotypic analysis. Although originally TRAP positive, HC1 cells lost this biochemical marker following 3 months in culture. Monoclonality of the cell line was confirmed by a clonal karyotypic abnormality characteristic of B-cell malignancies, and the presence of a single, distinctive fused terminal EBV fragment. The cells formed colonies in soft agar and were tumorigenic in irradiated nude mice. HC1 cells were sensitive to the antiproliferative effects of IFN-a and IFN-beta, but only moderately sensitive to the growth inhibitory effects of IFN-gamma. Incubating the cells in the presence of Type 1 IFN resulted in stabilization of cell numbers, without cellular proliferation or loss. Cell cycle analysis revealed that IFN-alpha resulted in a build-up of cells in the S phase of the cell cycle, suggesting a cytostatic effect of IFN on the growth of these cells. The HC1 cell line provides a model system which will be useful for in vitro studies of the biology and treatment of this disease.     

人脊索瘤细胞系CM-319的建立及其生物学特性的观察

目的　建立人脊索瘤细胞系 ,为脊索瘤研究提供实验模型。方法　取经病理证实的新鲜脊索瘤手术标本 ,进行体外原代组织块培养。对存活细胞进行形态学观察、组织化学染色、细胞周期检查、染色体分析、电镜观察、异种移植和体外侵袭实验等。结果　建成细胞系CM 319,经近两年的体外培养 ,已连续传代百余次。其形态学表现、组织化学染色、电镜观察和异种移植等均符合脊索瘤细胞特征。细胞倍增时间为 33h。细胞周期测定显示 :G1 期为 5 5 .6 % ,G2 期为 2 1.9% ,S期为2 2 .5 % ,G2 G1 为 1.90。染色体具有亚三倍体核型。异种移植成瘤率 10 0 % ,具有侵袭性。结论　CM 319是一株人脊索瘤细胞系 ,可用于对脊索瘤的研究。     

Current treatment options in hairy cell leukemia and hairy cell leukemia variant

Hairy cell leukemia (HCL) is a chronic B-cell lymphoproliferative disorder characterized by splenomegaly, pancytopenia and circulating lymphocytes displaying prominent cytoplasmic projections. HCL has usually an indolent course and the patients with asymptomatic disease do not require therapy. Treatment of progressive symptomatic HCL includes a variety of pharmacological approaches such as interferon-alpha (IFN-alpha), pentostatin (DCF) and cladribine (2-CdA), which have significantly improved the disease prognosis. 2-CdA and DCF seem to induce a similar high response rate and a long overall survival. They are also active in relapsed patients. More recently high activity of anti-CD20 monoclonal antibody (rituximab) and anti-CD25 (LMB-2) and anti-CD22 (BL-22) immunotoxins have increased the number of therapeutic options for HCL. Splenectomy may be still indicated in patients with massive, symptomatic splenomegaly or results in severe cytopenia. IFN-alpha may have a place in patients with very severe cytopenia, in HCL in pregnancy and in patients who have failed prior therapy with purine nucleoside analogs. HCL variant (HCL-V) is a distinct clinico-pathological entity which seems to be resistant to IFN-alpha and purine nucleoside analogs - DCF and 2-CdA. However, preliminary observations suggest that monoclonal antibodies - rituximab and BL-22 immunotoxin are highly active in this disorder even refractory to 2-CdA. In this review current therapeutic strategies in HCL and HCL-V are presented.     

毛细胞白血病和毛细胞白血病变异型患者免疫球蛋白重链可变区基因分子特征分析

  目的  本研究归纳毛细胞白血病（hairy cell leukemia,HCL）和毛细胞白血病变异型（hairy cell leukemia-variant,HCL-v）患者免疫球蛋白重链可变区（immunoglobulin heavy chain variable region,IGHV）基因分子特征,并探讨其与临床特征及预后的相关性。  方法  回顾性分析2004年12月至2020年1月在中国医学科学院血液病医院完善IGHV检测的29例HCL患者和15例HCL-v患者临床和生存资料。  结果   44例患者共检测出23种重排片段,VH4和VH4-34分别是两种疾病最常见的V区基因家族和重排片段。HCL和HCL-v患者中IGHV为突变状态的比例分别为72.4%和66.7%,发生VH4-34重排（VH4-34 rearrangement,VH4-34+）的患者IGHV突变率更低（P<0.001）。在HCL中,使用VH1基因家族患者脾大发生率更低（P=0.041）;而VH4-34+或IGHV未突变状态（IGHV-unmutated,IGHV-UM）的患者具有更高的乳酸脱氢酶（VH4-34+ P=0.049,IGHV-UM P=0.022）和β2微球蛋白（VH4-34+ P=0.039,IGHV-UM P=0.036）水平,且VH4-34+患者BRAF V600E突变率更低（20% vs. 85%,P=0.012）。单因素预后分析显示,VH4-34+是HCL患者无进展生存（progression-free survival,PFS）（P=0.001）和总生存（P=0.004）的不良预后因素,IGHV-UM则为HCL-v患者PFS（P=0.038）的危险因素。  结论  HCL和HCL-v患者对VH4基因家族及VH4-34存在偏向性使用,VH4-34+和IGHV-UM间存在明显共现性。在HCL中,VH4-34+与高肿瘤负荷及更差生存相关,而IGHV-UM是HCL-v患者PFS的危险因素。      

Establishment of a novel B-cell lymphoma cell line with suppressed growth by gamma-secretase inhibitors

A novel lymphoma cell line, designated TMD8 was established from cells of a patient with diffuse large B-cell lymphoma. TMD8 cells expressed HES1 mRNA, suggesting constitutive activation of Notch signaling. TMD8 cells expressed normal-sized Notch1 protein, and showed no mutations in the NOTCH1 gene. Cell growth was suppressed by gamma-secretase inhibitors (GSI). It was reported that GSI suppressed growth of T-cell acute lymphoblastic leukemia (T-ALL) cell lines, which frequently had NOTCH1 mutations. In addition to T-ALL, TMD8 is another unique cell line sensitive to GSI, and is useful to study effects of GSI in molecular targeting therapy.     

Establishment of an immature mast cell line from a patient with mast cell leukemia

A cell line showing many characteristics of immature mast cells has been established from the peripheral blood of a patient with mast cell leukemia. Cultured cells contain low levels of histamine, are stained metachromatically by toluidine blue, and contain chloroacetate esterase, aminocaproate esterase and tryptase activities. The cells lack T and B lymphocyte, as well as myeloid cell markers, and do not possess IgE receptors. Solid tumors of metachromatically positive cells have been successfully induced and serially passed in nude mice using 5-azacytidine transformed cells. This cell line may be useful for future studies of mast cells and their constituents.     

Establishment of the T-cell large granular lymphocyte leukemia cell line MOTN-1 carrying natural killer-cell antigens

A novel interleukin-2 (IL-2) dependent leukemia cell line MOTN-1 was established from the peripheral blood of a 63-year-old woman with T-cell large granular lymphocyte (LGL) leukemia in chronic phase. Primary peripheral blood leukemia cells were CD3+, CD5+, CD7+, CD56+, CD94+, CD161+, TcRalphabeta+, and HLA-DR+. The immunoprofile of the established cell line MOTN-1, however, showed CD3-, CD5-, CD7+, CD56+, CD94+, CD159+, CD161+, TcRalphabeta- and HLA-DR+; the MOTN-1 cells were cytoplasmatically positive for CD3varepsilon and the products of the T-cell receptor (TcR) genes beta and gamma. While the TcRbeta and TcRgamma genes were rearranged, the TcRdelta gene was found to be deleted. DNA fingerprinting and chromosome analysis identifying the t(2;6)(q?23;q?21) and t(12;18)(q13;q?22) alterations demonstrated the authenticity and the malignant nature of the cell line. The scientific significance of MOTN-1 lies in (1) the rarity of this type of leukemia cell lines, (2) the co-expression of various T- and natural killer (NK)-cell-associated markers, and (3) its unique chromosomal aberrations.     

Expression of Tac antigen on human immature B-cell lineage leukemic cells

Expression of interleukin 2 (IL-2) receptor (Tac antigen) on leukemic cells from 4 patients with acute lymphocytic leukemia (ALL) and 3 patients with blastic crisis of chronic myelogenous leukemia (CML-BC) was examined. Cells from 6 out of 7 patients did not carry immunoglobulins on their surfaces, but reacted with monoclonal antibodies (mAb) detecting B-cell related antigens such as B1, OKB2 and Leu12. Cells from two cases expressed Tac antigen immediately after cell separation. Phorbol 12-myristate 13-acetate (PMA) could induce Tac antigen in all cases. SDS-PAGE analysis of immunoprecipitates by anti-Tac mAb demonstrated that the molecular weight of Tac antigen on most of the leukemic cells was similar to that of Tac antigen present on Con A-stimulated normal lymphocytes. These leukemic cells poorly responded to exogenous recombinant IL-2. These findings suggest that IL-2 may interact with the immature and mature B cells, and play an important role in the differentiation of B lymphocytes.     

Relationship between human T cell leukemia virus-II and atypical hairy cell leukemia: a serologic study of hairy cell leukemia patients

Human T cell leukemia virus (HTLV-II) is an infrequently encountered human T cell leukemia virus first isolated from a patient with atypical hairy cell leukemia. Recently, we identified a second patient infected with HTLV-II who had a similar clinical syndrome of atypical hairy cell leukemia associated with peripheral T cell lymphocytosis. HTLV-II was detected by molecular hybridization studies, and more recently, by electron microscopy, in cell lines derived from the patient. Both patients came from the Los Angeles area and had spent several years in Alaska. As opposed to our two patients, 21 patients with more typical cases of hairy cell leukemia were seronegative for HTLV-II. Two additional cases of unusual T cell malignancy linked to HTLV-II have been described by other investigators and bear limited similarity to our index cases. Further studies are necessary to define the spectrum of malignancies linked to HTLV-II and to identify infected individuals for prospective study.     

Anaplastic neoplasm in a patient with hairy cell leukemia

A 63-year-old white man had a history of recurrent pneumonia, pancytopenia, and splenomegaly when the diagnosis of hairy cell leukemia was made on bone marrow biopsy examination. Splenectomy confirmed that diagnosis and his pancytopenia moderately improved. Three years following the diagnosis, the patient developed an upper abdominal mass involving the stomach wall that was found to be an anaplastic "large cell" neoplasm. Palliative radiotherapy was started, but the patient died 2 months later. Cytochemical studies of the anaplastic gastric neoplasm revealed cytoplasmic tartrate resistant acid phosphatase activity. Electron microscopy showed no epithelial differentiation. These observations suggest that the gastric neoplasm represented an evolution of hairy cell leukemia into a more aggressive tumor analogous to the transformation that occurs in other B-cell neoplasms.     

Establishment and characteristics of a human synovial sarcoma cell line

A human synovial sarcoma cell line (HSS-84), from a painful mass excised locally near the left sternoclavicular joint, was established and has been continuously propagated in vitro for more than one year through 54 passages till the end of 1985. Doubling time was 65 hr. The index of mitosis was 28.8%. The chromosome number for most of the cells was hypertriploid. The cells, stored in liquid nitrogen, had a good revival. Cytologically, some cells, showing elongated, spindle, stellate or spidery shape with prominent processes, were arranged in loose or bundled pattern, similar to sarcoma cells; some cells showed ovoid and polygonal in mosaic arrangement, similar to epithelioid cells. Both features indicated biphasic differentiation of the cells. By electron microscopy, the cells consisted of light and dark cells with microvilli and obvious abnormality. Histopathologically, the tumor, from which HSS-84 originated, was a biphasic differentiation synovial sarcoma. It was composed of malignant spindle interstitial cells and malignant epithelioid cells lining the clefts or spaces. The latter was similar to cultured cells by electron microscopy. HSS-84 was identical with the donor. HSS-84 establishment will be useful for research on diagnosis, therapy, origin and biphasic differentiation of the synovial sarcoma.     

Therapy of hairy cell leukemia with interferon

Hairy cell leukemia is a rare lymphoproliferative disorder which is morphologically characterized by circulating lymphatic cells with prominent 'hairy' cytoplasmatic projections. Patients typically present with pancytopenia and splenomegaly. The bone marrow cannot be aspirated because of reticulin fibrosis. Chemotherapy was unable to influence the course of the disease satisfactorily. Therefore, splenectomy was the treatment of choice. The introduction of alpha-interferons into the therapy of hairy cell leukemia was a decisive breakthrough and is exemplary for the use of interferons in the treatment of malignant diseases. However, there are still many questions to be answered. The discussion of clinical implications is achieving growing importance in consequence of the availability of diverse commercial alpha-interferons for treatment of hairy cell leukemia.     

Ultrastructural characteristics of the spleen in hairy cell leukemia.

Eighteen spleens derived from patients with hairy cell leukemia (HCL) were analyzed by correlative scanning and transmission electron microscopy. In 15 of the cases, the white pulp areas were markedly decreased or absent when compared to normal spleens, although few hairy cells were observed within this region. In only one case did the white pulp appear normal. In all HCL cases, hairy cells were observed within normal, dilated, and abnormal sinuses. The abnormal sinuses contained hairy cells of typical morphology attached to other hairy cells, to endothelial lining, and to erythrocytes. The degree of sinus filling by hairy cells varied from loosely- to tightly-packed. Endothelial cells exhibiting degenerative changes, such as swelling with smooth surfaces and dilated intercellular spaces, were frequently seen. These results indicate that in addition to the previously described overcrowding of the spleen by hairy cells, the splenic tissue itself is considerably altered and sometimes severely damaged in patients with HCL.     

Epstein-Barr virus positive large B-cell lymphoma arising in a patient previously treated with Cladribine for hairy cell leukemia

We describe the case of a patient treated with 2-chloro-2'-deoxyadenosine, CdA or Cladribine for hairy cell leukemia who subsequently developed an Epstein Barr virus (EBV)-positive polymorphous large B-cell lymphoma (p-LBCL). The time interval between Cladribine therapy and development of p-BCL was 11 months and morphologically resembled an EBV-positive post transplant lymphoproliferative disorder (PTLD). Molecular genetic studies for EBV-clonality by Southern blot hybridization showed a clonal population of infected cells, implying that this was an EBV induced lesion. The chronology of events suggest that Cladribine, a purine analog which has been previously described to induce long-lasting immunodeficiency, can, in some cases, weaken the host defense mechanism to a level at which an innocuous EBV infection may transform the normal lymphoid cells into an aggressive neoplasm. Unlike most methotrexate-related lymphoproliferative disorders (LPDs), which undergo spontaneous remission after discontinuation of therapy, LPDs secondary to purine analogs often fails to resolve after discontinuation of therapy and requires additional therapy. Our patient was treated with rituximab following the diagnosis of p-LBCL, with the goal of improving the pancytopenia to permit chemotherapy. However, the patient failed to show any dramatic improvements in counts, developed systemic symptoms and progressive ascites. He expired 3 weeks after a second dose of rituximab. Cladribine is a potent immunosuppressive agent and should be included with the list of immunosuppressive agents that may be associated with EBV-related B-cell lymphoproliferative disorders.     

Cell-surface characteristics of hairy cell leukemia in seven patients.

Surface marker studies were performed on "hairy cells" from 7 patients with hairy cell leukemia (HCL). Using sensitive analytic techniques including specific antisera and Fluorescence Activated Cell Sorter (FACS-1), further definition of the abnormal cell was achieved. Four different antisera were used in infestigating the cell surface characteristics of these patients: anti-p23,30, an antiserum reactive with B cells and a subset of monocytes, anti-311, which reacts only with T cells, pepsin digested anti-F(ab')2 which reacts with B cells only and pepsin digested anti-lysozyme reactive with monocytes and myeloid cells, but not with B or T cells. In all cases strong reactivity was observed with anti-p23,30 and anti-F(ab')2, but no reactivity with anti-311. Five out of the seven cases were reactive with anti-lysozyme in a pattern similar to normal monocytes. Furthermore, when cells were separated according to binding to anti-p23,30, anti-F(ab')2 and anti-lysozyme and in two cases, according to cell size, the majority of reactivity and large cells were "hairy" when examined under microscopy. In contrast, the small and nonreactive (dull cells) appeared as normal mature lymphocytes. Thus, our data supports the view that HCL cells bear in most cases B cell and monocytic membrane markers.     

Establishment of the B cell precursor acute lymphoblastic leukemia cell line MUTZ-5 carrying a (12:13) translocation.

Continuous leukemia-lymphoma cell lines are important research tools, in particular as starting material for the cloning of recurrent translocations. In 1998, we established the continuous leukemia cell line MUTZ-5 and its two simultaneous sister cell lines MUTZ-6 and MUTZ-7. The primary specimen was obtained from the peripheral blood of a 26-year-old man with B cell precursor acute lymphoblastic leukemia at relapse carrying a t(12;13). The immunoprofile of MUTZ-5 corresponds to that of a precursor B cell. The immunoglobulin heavy chain gene was found to be rearranged. Despite receptor expression, none of the cytokines examined enhanced proliferation; several cytokines had significant inhibitory effects. Giemsa-banding cytogenetics showed the following karyotype which was identical in all three sister cell lines: 45<2n>X, -Y, t(12;13)(p12;q13-14). The karyotype and DNA fingerprinting confirmed the malignant nature and the authenticity of the cell line, excluding cross-contamination with other cells. MUTZ-5 represents a new unique leukemia B cell line; its scientific significance lies in the t(12;13).