Kappa immunoglobulin light chain gene rearrangement in a T-lineage chronic lymphocytic leukemia

Until recently, only B-lineage lymphoid cells were observed to rearrange kappa immunoglobulin light chain genes. The authors examine peripheral blood mononuclear cells from a patient with chronic lymphocytic leukemia. More than 90% of these cells bound T-lymphocyte specific antibodies, failed to bind B-lymphocyte specific antibodies, had rearranged T-cell receptor beta-chain genes and had retained immunoglobulin heavy chain genes in the germline configuration. Despite these T-lineage markers, the majority of these cells had rearranged kappa immunoglobulin light chain genes. This provides the first conclusive evidence for rearranged kappa genes in malignant T-lineage cells and warns that gene rearrangement studies alone cannot indicate tumor cell lineage. To detect T-lineage cells that rearrange immunoglobulin genes, multiple immunophenotypic and genotypic parameters must be evaluated. These cells may provide important models to study how normal and malignant cells rearrange lymphocyte receptor genes.