Prognostic significance of immunoglobulin isotype expression in B-cell non-Hodgkin's lymphoma

Lymph node biopsies from 170 patients with untreated non-Hodgkin's lymphomas (NHL) of B-cell type were immunophenotyped and analyzed for the Ig heavy and light chain isotypes and their relation to prognosis. IgM alone was more frequently seen in high grade (53%) compared to low grade (20%) NHL. In contrast, IgM/IgD isotypes were more frequent in low grade (47%) than in high grade NHL (20%). IgG or IgA heavy chain, alone or in combination with other heavy chain isotypes, were expressed with the same frequencies in both low (32%) and high (27%) grade NHL. Clonally restricted kappa light chain expression was noted in 64% of low grade and 66% of high grade NHL patients. Only in chronic lymphocytic leukemia (CLL) and immunocytoma (IC) was a shorter survival time noted for patients with tumors expressing IgG and/or IgA heavy chains compared to those expressing IgM or IgM/IgD (P less than 0.001). This difference was not seen as being low grade follicle center cell-derived (FCC) or high grade NHL. The expression of kappa light chains on the tumor cells was associated with a significantly longer survival in CLL and IC patients only (P less than 0.01).