One hundred and twenty-four sera from patients with various leukemic B-cell chronic lymphoproliferative diseases were investigated at diagnosis by ELISA for their soluble CD23 content. Immunophenotyping was carried out in all patients, and in a selected subset the mean number of membrane-bound CD23 molecules per cell was also investigated. Seventy-three patients had typical B chronic lymphocytic leukemia, 41 leukemic B-cell disorders with atypical morphological and/or immunophenotypic features, 5 had low-grade follicular cell lymphoma in the leukemic phase, and 5 had splenic lymphoma with villous lymphocytes. Soluble CD23 levels were significantly higher than in normal sera (mean +/- SD: typical B chronic lymphocytic leukemia 3,650 +/- 4,654 U/ml, atypical B chronic lymphocytic leukemia 3,440 +/- 4,671 U/ml, follicular cell lymphoma 3,200 +/- 1,511 U/ml, splenic lymphoma with villous lymphocytes 8,236 +/- 7,294 U/ml, controls 137 +/- 128 U/ml; P < 0.001). More advanced Rai's stages were related to higher soluble CD23 levels (P < 0.01), both in typical and atypical B chronic lymphocytic leukemias, the highest levels and the best correlation with the absolute number of circulating CD19+ cells (r = 0.50) being observed in the typical form. The number of membrane-bound CD23 molecules per cell was significantly higher in typical than in atypical B chronic lymphocytic leukemias (mean number 156,727 +/- 94,668 vs. 12,010 +/- 10,643, P < 0.001). Our data suggest that soluble CD23 levels correlate with the clinical and biological features of leukemic B-cell lymphoproliferative disorders.
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