Immunoglobulinopathies in patients with angioimmunoblastic T-cell lymphoma.

S A Mariina,D S Badmazhapova,E E Zvonkov,M N Sinitsyna,N G Chernova,N P Soboleva,V N Dvirnyk,Y E Vinogradova,Y V Sidorova,V G Savchenko

doi:10.26442/terarkh201890751-56

Abstract

The aim of the study was to characterize quantitative and qualitative immunoglobulinopathies in patients with AITL at the onset of the disease. 55 patients with newly diagnosed AITL were enrolled in the study, the male/female ratio was 30/25; median age was 61 (29-81) years. Diagnosis was based on standard WHO criteria. Immunochemical studies of blood serum included serum protein electrophoresis/immunofixation, nephelometric quantification of total immunoglobulins, serum free light chain assay. Quantitative and qualitative immunoglobulinopathies were determined in 49 (89,1%) of 55 pts. Quantitative immunoglobulinopathies were revealed in 47 (85.5%) of 55 cases, qualitative - in 14 (25,5%). Combination quantitative and qualitative immunoglobulinopathies was observed in 12 (21,8%) of 55 pts. The detected immunoglobulinopathies were divided into 4 groups: polyclonal hypergammaglobulinaemia, hypogammaglobulinaemia, oligoclonal gammapathy, and monoclonal gammapathy. Polyclonal hypergammaglobulinaemia was marked in 41 (74.5%) of 55 pts, elevated level of IgG was determined in 27 (49,15%) of 55 cases, IgM - in 18 (32,7%) and IgA - in 21 (38.2%). Interestingly, polyclonal IgE hypergammaglobulinaemia was detected in 12 (48,0%) of 25 cases of performed studies. Hypogammaglobulinaemia was detected in 8 (14,5%) of 55 cases. Oligoclonal gammapathy was determined in 4 (7.3%) of 55 pts. Monoclonal gammapathy was revealed in 11 (20,0%) of 55 cases. The amount of monoclonal immunoglobulin varied from 2.6 to 14.1 g/l. Monoclonal immunoglobulin Gk was detected in 5 of 11 pts, Gλ - in 2, Mλ - in 2, Mk - in 2. Monoclonal gammapathy was accompanied by polyclonal hypergammaglobulinaemia in 9 of 11 cases, hypogammaglobulinaemia - in 2. Quantitative and qualitative immunoglobulinopathies are observed in most patients at the onset of AITL. Quantitative abnormalities were determined more often than qualitative. Monoclonal gammapathy can be a manifestation of lymphoproliferation and other concomitant disorders. The prognostic value of immunochemical parameters is still unclear and requires dynamic observation and study.

Highlights

The characteristics of immunoglobulinopathies observed in Angioimmunoblastic T-cell lymphoma (AITL) are scarce
The detected immunoglobulinopathies were divided into 4 groups: polyclonal hypergammaglobulinaemia, hypogammaglobulinaemia, oligoclonal gammapathy, and monoclonal gammapathy
Monoclonal gammapathy was accompanied by polyclonal hypergammaglobulinaemia in 9 of 11 cases, hypogammaglobulinaemia – in 2

Summary

Conclusions

Quantitative and qualitative immunoglobulinopathies are observed in most patients at the onset of AITL. АИТЛ – ангиоиммунобластная Т-клеточная лимфома ВОЗ – Всемирная организация здравоохранения. Ангиоиммунобластная Т-клеточная лимфома (АИТЛ) – Т-хелперов [1]. При анализе структуры зрелых NK/Т-клеточных лимфом, наблюдавшихся в Гематологическом научном центре за период 2001–2010 гг., частота АИТЛ составила лишь 3,1%, что, вероятно, связано с клинико-морфологическим разнообразием и трудностями диагностики этой неходжкинской лимфомы [3, 4]. Первоначально АИТЛ трактовалась как неопухолевый лимфопролиферативный процесс с гипериммунной реакцией В-клеток, приводящий в большинстве случаев к фатальному исходу [6]. Сведения об авторах: Соболева Наталья Павловна – врач централизованной клиникодиагностической лаборатории, http://orcid.org/0000-0002-1903-2446. Марьина Салия Ахсановна – врач централизованной клинико-диагностической лаборатории, http://orcid.org/0000-0002-9375-4076. Сидорова Юлия Владимировна – к.м.н., с.н.с., http://orcid.org/00000003-1936-0084. Отд-нием интенсивной высокодозной химиотерапии лимфом с круглосуточным и дневным стационаром, http://orcid.org/0000-0002-2639-7419. В нашей статье мы представили анализ иммунохимических показателей у 55 первичных больных АИТЛ, наблюдавшихся в ФГБУ «НМИЦ гематологии» Минздрава России за период 2002–2017 гг

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