Blood lymphocytes surface markers and clinical findings in chronic lympoproliferative disorders

Surface receptors on peripheral blood lymphocytes have been studied in 43 cases with chronic lymphocytic leukaemia (CLL), and five cases with lymphoma and overspill. One quarter of the cases with CLL had lymphocytes with no detectable surface immunoglobulin (SIg) by direct fluorescent antibody staining. The remainder had SIgM, which was associated with SIgD in one third of the cases. 70% of the SIg negative group had extensive extramedullary involvement (EMI) compared with 35% of the SIg positive group at presentation; correspondingly more of the SIg negative group were treated. 46% of the SIg negative group were CLL patients of more than 3 years standing compared with 9% of the SIgM+D group and 32% of the SIgM group. Some explanations for this pattern are discussed.