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Certain markers for B lymphocytes (SIg, EAIgG, EAIgMC3b, EAIgMC3d, M-R) and T lymphocytes (E-R, EAIgG, EAIgM) were applied in order to characterize circulating neoplastic cells in non-Hodgkin lymphomas (NHL) of low and intermediate malignancy. In all cases, the diagnoses were based on the histological examination of lymph nodes, bone marrow, or skin biopsies. According to the Kiel classification, the diagnoses were as follows: chronic lymphocytic leukemia (CLL) n = 145. Immunocytoma (Ic) n = 39. Centrocytic (Cc) and centroblastic/centrocytic lymphoma (Cb/Cc) n = 17. Hairy-cell leukemia (HCL) n = 10. Prolymphocytic leukemia (PLL) n = 6 and Sezary's syndrome n = 3. In only 8 of the 220 cases did the leukemia cells show T characteristics. In leukemic B-cell lymphoma, a uniform phenotype was observed for B-CLL, characterized by a weak SIgm staining with or without SIgD, the presence of C3d-receptors and a high percentage of M-R. This phenotype was also detected in one third of the cases of immunocytoma. The cells of BPLL and leukemic CC and CB/CC were characterized by a stronger SIg staining, a variable formation of complement receptors and, in most cases, absence of M-R. In all cases of B-cell lymphoma, the monoclonality of the cell proliferation could be confirmed by the restriction to a single L-chain type. This also applies to the 10 cases of HCL, although in the majority of these cases, several heavy-chain classes could be detected at the malignant cells.

Using a reverse hemolytic plaque assay as the effector system, we studied B-lymphocyte function in 12 patients after posttraumatic splenectomy, as well as in 25 normal individuals. The time interval between the splenectomy and the immunological studies varied between 2 days and 7 years. Compared to normal individuals, the splenectomized patients had markedly elevated numbers of spontaneous immunoglobulin-secreting cells (ISC) and severely decreased responses to the polyclonal activator pokeweed mitogen. A tendency towards normalization of these abnormalities, especially the high spontaneous ISC levels, could be observed during the time interval extending up to 7 years after splenectomy. In order to characterize the mechanism responsible for the altered immune response in splenectomized patients, co-culture experiments with unseparated and separated lymphocytes were performed. These revealed an impaired T-helper cell capacity as well as an intrinsic B-cell defect. Marker analyses with monoclonal antibodies revealed normal proportions with the exception of OKT 4 positive and B 1 positive cells that identify T-helper/inducer and peripheral B-cells respectively. We conclude that immune dysfunction in peripheral blood lymphocytes of splenectomized patients involves mainly the B-cell as well as the T-helper/inducer-cell population.