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Chronic myelomonocytic leukemia with paraproteinemia but no detectable plasmacytosis A detailed cytological and immunological study
Author(s) -
Barnard D. L.,
Burns G. F.,
Gordon J.,
Cawley J. C.,
Barker C. R.,
Hayhoe F. G. J.,
Smith J. L.
Publication year - 1979
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197909)44:3<927::aid-cncr2820440321>3.0.co;2-o
Subject(s) - paraproteinemia , chronic myelomonocytic leukemia , myeloid , medicine , myeloid leukemia , pathology , antigen , acute myelomonocytic leukemia , immunology , microbiology and biotechnology , bone marrow , biology , multiple myeloma , myelodysplastic syndromes
A patient with chronic myelomonocytic leukemia with IgG K paraproteinemia, but no detectable plasmacytosis, is described. The patient was entering a blastic phase at the time of the most detailed studies. Cytological, cytochemical, and ultrastructural studies revealed a mixed myeloid proliferation with granulocytic forms predominating over monocytic elements. A variety of ultrastructural abnormalities, including defective granulation, was observed but no cells with highly developed rough endoplasmic reticulum were observed. Immunological marker studies showed that the mature myeloid cells possessed receptors for the Fc of IgG and weakly expressed the Ia‐like P29/34 antigen. The mature myeloid cells also expressed both surface and intracytoplasmic Ig restricted to IgG K, and this IgG K persisted after 4 weeks in culture. A reverse plaque assay showed that the myeloid cells were capable of releasing IgG K in vitro , but studies involving the incorporation of radio‐labeled amino acids showed no detectable Ig production by the myeloid cells. The possible interpretations of these data are discussed in some detail in relation to previous reports of paraproteinemia in myeloid proliferative disorders.