Evidence is presented that at least 17% of microscopically normal bone marrow samples obtained from patients with undifferentiated lymphomas contain occult tumor cells. Of 19 microscopically normal bone marrow samples tested, continuous tumor cell lines were obtained from 4. A tumor cell origin was confirmed by the presence of an 8;14 chromosomal translocation in each case, and HLA typing confirmed the patient origin of the cell line. In two other patients, direct cytogenetic examination of microscopically normal bone marrow samples revealed karyotypes containing 8:14 translocations or a 14q+ chromosome. These findings indicate that undifferentiated lymphomas are often more widespread than is clinically appreciated. The presence of submicroscopic marrow involvement is also of significance to the design and analysis of treatment protocols involving autologous marrow infusion.
Using an improved electroimmunofixation technique that combines the sensitivity of high resolution agarose gel electrophoresis with the specificity of immunoprecipitation, we have demonstrated monoclonal immunoglobulin bands in the serum of patients with undifferentiated lymphomas of Burkitt and non-Burkitt types. Monoclonal bands were detected in the serum of 12 of 21 patients with extensive tumor, and 1 of 10 patients with minimal tumor. All of the bands were identified as IgM of a single light chain class. Such bands were not detected in the serum of patients with lymphoblastic lymphoma (7) or African Burkitt's lymphoma (6). There was disappearance of the bands after therapy and reappearance at relapse. These findings, coupled with previously reported in vitro information, indicate that undifferentiated lymphoma cells secrete immunoglobulin of IgM isotype. Therefore, such monoclonal bands may be of potential value as tumor markers.
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