Hairy cell leukemia: at the crossroad of somatic mutation and isotype switch

Blood. 2004 Nov 15;104(10):3312-7. doi: 10.1182/blood-2004-03-0950. Epub 2004 Jul 29.

Abstract

Hairy cell leukemia (HCL) commonly expresses multiple immunoglobulin isotypes, a feature rare in other B-cell malignancies or in normal B cells. In HCL, there is no phenotypic evidence for subpopulations, and single cells from one previous case contained transcripts for several isotypes. This raises the questions of the differentiation status of the cell of origin and of posttransformation events. We have investigated 9 cases, all expressing multiple immunoglobulin isotypes. Multiple tumor-derived variable-(diversity)-joining-constant mu delta, gamma, alpha (V(D)J-Cmu, delta, gamma, alpha) transcripts were confirmed in single cells of a further case. All cases were negative for germinal center (GC)-associated markers CD27 and CD38. Seven of 9 cases had mutated V(H) genes, with low levels of intraclonal heterogeneity, but 2 of 9 were unmutated, indicative of pre-GC origin. Eight of 9 cases expressed activation-induced cytidine deaminase (AID), a molecule essential for somatic mutation and isotype switch. All cases expressed germ line heavy-chain I exon (I(H))-C(H) transcripts which paralleled surface immunoglobulin (sIg) isotype. Significantly, no circle transcripts indicative of deletional recombination of switched isotypes were detectable in 9 of 9 cases. These data indicate heterogeneity in the cell of origin in terms of mutational status, but reveal common features of AID expression and isotype-switching events occurring prior to deletional recombination. Both mutational and switching events may be influenced by environmental factors at extrafollicular sites.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • ADP-ribosyl Cyclase / metabolism
  • ADP-ribosyl Cyclase 1
  • Antigens, CD / metabolism
  • Biomarkers, Tumor
  • Cytidine Deaminase
  • Cytosine Deaminase / genetics
  • Gene Deletion
  • Gene Expression Regulation, Leukemic / immunology
  • Germinal Center / metabolism
  • Humans
  • Immunoglobulin A / genetics
  • Immunoglobulin Class Switching / immunology*
  • Immunoglobulin D / genetics
  • Immunoglobulin G / genetics
  • Immunoglobulin M / genetics
  • Leukemia, Hairy Cell / genetics*
  • Leukemia, Hairy Cell / immunology*
  • Membrane Glycoproteins
  • Mutation / immunology
  • Tumor Necrosis Factor Receptor Superfamily, Member 7 / metabolism

Substances

  • Antigens, CD
  • Biomarkers, Tumor
  • Immunoglobulin A
  • Immunoglobulin D
  • Immunoglobulin G
  • Immunoglobulin M
  • Membrane Glycoproteins
  • Tumor Necrosis Factor Receptor Superfamily, Member 7
  • ADP-ribosyl Cyclase
  • CD38 protein, human
  • ADP-ribosyl Cyclase 1
  • AICDA (activation-induced cytidine deaminase)
  • Cytosine Deaminase
  • Cytidine Deaminase