IntroductionB-cell receptor (BCR) signaling regulates several B-cell fate decisions throughout development, [1][2][3][4][5] and continued expression of the signaling subunits of the BCR is required for survival of mature B cells. 6,7 Because BCR signaling is so closely linked with survival and proliferation of B cells, it is thought that alterations in BCR signaling may support lymphomagenesis. 8,9 We have previously developed an approach to identify profiles of aberrant signaling in individual malignant or normal cells. 10,11 The identification of altered BCR signaling in lymphoma cells might provide new opportunities to improve cancer therapy, as targeted inhibition of signaling associated with cancer progression and maintenance has proved successful for other malignancies. 12 This study of BCR signaling in lymphoma builds on extensive prior work mapping the BCR signaling events 13 and our own studies of BCR signaling kinetics in primary peripheral blood B cells. 14 Here we measure BCR-mediated Btk, Syk, Erk1/2, and p38 ( Figure 1A) signaling kinetics within different types of B cells in follicular lymphoma (FL) tumor specimens. These 4 signaling nodes are highlighted in a model of BCR signaling activation and regulation. Btk and Syk are key proximal signal transducers required for effective BCR-mediated activation of PI3K and PLC␥2. [15][16][17] As such, changes to BCR signaling in lymphoma might be expected to alter the activity of Btk and Syk. Downstream effectors of BCR signaling include the MAPK family proteins Erk1/2 and p38.Signaling originating at the BCR can either promote proliferation or initiate programmed cell death, and it is not yet known whether BCR signaling in FL B cells is unaltered, amplified, or suppressed. Supporting the idea that BCR signaling might be altered in FL, evidence exists that the BCR in these malignant cells has somatic mutations that enable N-glycosylation. 18,19 If BCR signaling supports the survival of lymphoma B cells, we would expect to see amplified signaling specific to FL B cells. However, BCR signaling might also induce apoptosis or cell cycle arrest in lymphoma B cells. The effectiveness of monoclonal antibody therapy directed against the idiotype of the lymphoma BCR 20,21 has been directly correlated with the ability of these antibodies to induce BCR signal transduction. 22 Thus, there is a need to determine whether BCR signal transduction is altered in lymphoma, to identify the direction of this alteration (potentiation or attenuation), and to dissect whether signaling changes are specific to lymphoma B cells or common to all B cells at the tumor site. The latter might occur if the lymphoma tumor microenvironment supported altered BCR signaling, in which case both normal and malignant B cells would be expected to show abnormal signaling.Flow cytometry is particularly well suited to address these needs as it can measure multiple signaling events in individual cells while simultaneously distinguishing among cell subsets. 10 Measuring several phosphoproteins by flow ...