Immunological markers in hairy-cell leukaemia

The dissertation consists of six chapters. Chapter 1 presents a brief introduction on immunological markers. Chapter 2 describes the discovery of a previously unrecognised marker in hairy-cell leukaemia (HCL), a receptor for IgM. The rosette method used to reveal this receptor, and the conditions affecting rosette formation are described. A kinetic study of this receptor is used to provide a measure of membrane turnover in HCL. The distribution of the IgM receptor among normal and malignant haemic cells is investigated. Chapter 3 considers a variety of other immunological markers in HCL. Previous controversy in the literature concerning the presence of a receptor for complement on hairy cells is resolved and new information is provided about the presence of other markers on hairy cells. Chapter 4 presents experiments designed to investigate conflicting evidence regarding the nature of the hairy cell. Monocytic properties are measured and weighed against features of hairy cells which align them with the B-lymphocyte series. The presence of intrinsic surface immunoglobulin (Sig) is used as evidence for the B-cell nature of HCL. The results obtained showing only IgG on the surface of some cases of HCL, and multiple heavy chain isotypes on others, provide a solution to the confused literature regarding the presence of SIg on hairy cells. Two unusual cases of immunoproliferative diseases are extensively investigated in Chapter 5 in order to demonstrate some of the problems associated with immunological marker studies. Chapter 6 reviews the thesis and draws conclusions about the nosology of HCL. A possible position for HCL in schemes of B-cell differentiation is given. Several papers of unconnected work submitted during the period of research for the dissertation are also included for consideration by the Examiners.Digitisation of this thesis was sponsored by Arcadia Fund, a charitable fund of Lisbet Rausing and Peter Baldwi