Analysis of human leukaemic cells using cell surface binding probes and the fluorescence activated cell sorter

Cell surface binding fluorescent ligands have been used to distinguish between different types of leukaemic cells and between leukaemic cells and their presumed normal counterparts or progenitors. Binding of these probes was evaluated using the Fluorescence Activated Cell Sorter (FACS) which provides both rapid, objective and quantitative recording of fluorescent signals from individual cells plus physical separation of cells of particular interest. Binding sites for cholera toxin (monosialoganglioside GM1) were found to be normally expressed in chronic leukaemias but greatly diminished or absent in acute leukaemias irrespective of their morphological type. Antibodies specific for the common form of acute lymphoblastic leukaemia (ALL, non-T, non-B) have been produced in rabbits. After extensive absorption and testing these were shown to define a cell surface antigen of non-T, non-B type ALLs. The antigen is absent from other leukaemias with two interesting exceptions--the majority of acute undifferentiated leukaemias express the antigen as do a proportion of chronic granulocytic leukaemias in blast crisis relapse. The anti-ALL antibodies can therefore be used to distinguish different leukaemias and, more significantly, can identify the existence of relatively rare leukaemic cells in the blood of untreated patients and the marrow of treated patients considered to be in remission.