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1.Polyclonal anti-kappa and anti-lambda both FITC and PE are preferred over
monoclonal reagents followed by
2. combinations of CD19/polyclonal anti-kappa and CD19/polyclonal
anti-lambda followed by
3. three-color analysis:isotyope/19/45; kappa/19/45; lambda/19/45;
FITC-kappa/lambda, PE-CD5, PerCP-CD19.
We have been trying kappa/lambda/CD20 (BDIS,CD20 percp) and kappa
PE/lambda FITC, CD19 Tri-color and they seem to work okay. I also like
IgD/IgM/CD19 (FITC, PE, Tri-color, CAL TAG) as it appears in normal
ndidvidual to detect a bimodal population of B cells. We have also tried
K/L/B4 from tago and kappa/B4 (ortho) and lambda/B4 (ortho).
4. Hypaque ficoll prepared cells preferred over washed cytoshed whole blood
lysis by one investigator. On two separate occassions w have investaged
cytosheding for the detection of surface Ig. Once on hypque ficoll pepared
cells and once on whole blood. It may be time to do it again.
4.Serveral people recommended DAKO, Tago, Caltag and BDIS.
5.Several people have been working on differentiating B-CLL, hairy cell
leukemia and plasma cells using various 2 and 3 color panels including the
detection of cytoplasmic Ig.
6.Something was said about the best KS test being done at the Mayo clinic
but I am unable to locate that message.
Comment. Kappa lambda analysis is very useful clinically for the diagnosis
of a monoclonal B cell lymphocytosis. It is useful in the detection of
residual disease. We like it in our B-CLL studies. We would like to be
able to do a good kappa lambda analysis in third generation family members
in kindreds with famiolial B-CLL. Recently in collaboration with Robt Vogt
of the CDC we have somes data that suggests that the incidence of early
B-CLL may be higdher than previously suspected, particularly with an aging
population. We have planned a workshop to discuss this matter at the CDC
in June 1995. I will send a copy of the tentative schedule to dthe
Cytometry Mailing List separately. However, I would like to keep this
discusion going. I would be interested in learning about your experience
with early, asymptomatic, unexpected, monoclonal B cell lymphocytosis.
Gerald E. Marti
Flow and Image Cytometry Section
Laboratory of Medical and Molecular Genetics
Division of Cell and Gene Therapies
CBER FDA NIH Bdg 29 Rm 502
8800 Raockville Pike
Bethesda,MD 20892
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