RE: B cell antibodies

From: Stetler-Stevenso, Maryalice (NCI) (stetler@mail.nih.gov)
Date: Tue Jun 04 2002 - 15:17:21 EST


Well Joern, I have seen many, many, many cases of malignant cells treated
with anti-CD20 (as well as other antibodies) and they have been CD19
positive. The CD20 is, of course, negative but that is all. I have seen
cases of lymphoma in which the treatment does results in selection of cells
with a lower level expression of the antigen of interest but that is a
different matter. We are talking about a patient receiving Rituxan
(anti-CD20) and whether or not all the B cells should be negative for CD19
and CD22. As a rule they aren't . I have been flowing cases of B cell
neoplasms that have been treated with Anti-CD19, anti-CD20, anti-CD22 and
Anti-CD25 for about 10 years and I have not seen the absence of all the B
cell antigens. So, based upon practical experience, I would say you are
wrong in this issue.

Maryalice Stetler-Stevenson, M.D., Ph.D.
Chief, Flow Cytometry Unit
Laboratory of Pathology, NCI, NIH

Sometimes you're the windshield, sometimes you're the bug.

> ----------
> From:		Joern Schmitz
> Sent:		Tuesday, June 4, 2002 2:26 PM
> To:	Stetler-Stevenso, Maryalice (NCI)
> Cc:	avispeters@netscape.net
> Subject:	RE: B cell antibodies
>
> Unfortunately, Maryalice you are wrong on this issue. B cells tend to shed
> or internalize other molecules once you start to bring antibodies onto the
> cell surface. From an outside few the B cells appear to be "naked" - CD19
> negative, CD20 negative, ... . This behavior saves some of the malignant B
> cells and they start to reexpress their molecules once the antibody
> treatment is over and the titers are down. The only way to reliably test
> whether you have eliminated the B cells truly is to use an
> intracytoplasmatic staining reagent like CD79a.
>
> Joern E. Schmitz, MD
> Assistant Professor of Medicine
> Harvard Medical School
>
> Division of Viral Pathogenesis
> Department of Medicine
> Beth Israel Deaconess Medical Center
> Research East 213D
> 330 Brookline Avenue
> Boston, MA  02215
>
> Phone: 617-667-5206
> Fax:	 617-667-8210
> http://research.bidmc.harvard.edu/v_path
>
>
> -----Original Message-----
> From: Stetler-Stevenso, Maryalice (NCI) [mailto:stetler@mail.nih.gov]
> Sent: Tuesday, June 04, 2002 9:09 AM
> To: Cytometry Mailing List
> Subject: RE: B cell antibodies
>
>
> Rituxan should not have done that. We have seen CD20 negativity after
> treatment but the other B cell antibodies worked well. This unmarked
> population could be something other than lymphoid or the CD19 and CD22
> didn't make it into the tube (happens in the best of labs on occasion).
>
> Maryalice Stetler-Stevenson, M.D., Ph.D.
> Chief, Flow Cytometry Unit
> Laboratory of Pathology, NCI, NIH
>
> Sometimes you're the windshield, sometimes you're the bug.
>
> > ----------
> > From:	avispeters@netscape.net
> > Sent:	Monday, June 3, 2002 4:24 PM
> > To:		Cytometry Mailing List
> > Subject:	Re: B cell antibodies
> >
> >
> > Speaking of Rituxan monitoring, we had a Dr. last week that ordered a
> > CD20 for Rituxan
> > therapy monitoring and he wanted to know how many B cells were
> > present. Looking at the
> > total lymph gate, there were about 70% T cells (CD3+), about 8% NK
> > cells (CD56+16+/CD3-)
> > which would leave about 22% that should have been B cells. I could not
> > get those B
> > cells to stain with CD19, CD20, or CD22. There was always a population
> > totally negative
> > (0% for all 3 B markers) which amounted to about 20%. I thought the
> > Rituxan was only
> > supposed to block CD20. Could someone shed some light on this problem
> > for me.
> > Avis Peters
> > United Hospital
> > Flow Cytometry Lab
> > St. Paul, MN
> >
> >
> >
> > "Timothy Singleton, M.D." <tsingleton@smtpgw.beaumont.edu> wrote:
> >
> > >
> > >Cytoplasmic CD79a.
> > >
> > >Tim Singleton, MD
> > >Flow Cytometry
> > >Beaumont Hospital
> > >Royal Oak, MI
> > >
> > >>>> Paula Fukushima <pif@mail.nih.gov> 05/24/02 09:40AM >>>
> > >
> > >Hi List,
> > >	 Does anyone have an idea of B cell antibodies to use to follow
> > >disease
> > >in B cell lymphomas
> > >with patients now being given anti-CD22(Epratuzumab) and
> > >anti-CD20(Rituxamab) besides CD19?
> > >
> > >	     Thanks, Paula
> > >
> > >
> > >Paula Imus
> > >Flow Cytometry
> > >LP, NCI, NIH
> > >10 Center Drive MSC-1500
> > >Bethesda, Md. 20892-1500
> > >
> > >
> > >
> > >
> >
> >
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