DBA.44 (Hairy Cell Leukemia)

Sources/Clones
Dako and Immunotech

Fixation/Preparation
The antibody is immunoreactive in formalin-fixed, paraffin-embedded tissues with immunoreactivity enhanced by proteolytic digestion but not by HIER.

Background
DBA.44 recognizes an unknown fixation-resistant B-cell differentiation antigen expressed by mantle zone lymphocytes, reactive immunoblasts, monocytoid B cells and a small proportion of high- and low-grade lymphomas (Al Saati et al, 1989; Hounieu et al, 1992). The monoclonal antibody was one of four generated against a B-lymphoma cell line (DEAU-cell line) grafted in athymic nude mice. Within the group of low-grade B-cell lymphomas, DBA.44 reacted principally with hairy cell leukemia. Among node-based lymphomas, the strongest membrane staining was observed in centroblastic, immunoblastic and monocytoid B-cell lymphomas.

Applications
In a study of bone marrow specimens from 166 patients with hairy cell leukemia, strong positive staining of the ''hairy" surface membranes was observed in routinely fixed and decalcified bone marrow biopsies of nearly all cases (Hounieu et al, 1992). Subsequent studies have proven the usefulness of DBA.44 in the identification of hairy cell leukemia, particularly in the detection of minimal residual disease following treatment (Wheaton et al, 1996). DBA.44 has been successfully applied to peripheral blood cytospin preparations and for ultrastructural labeling (Cordone et al, 1995).
The antibody has also been successfully applied to methyl-methacrylate embedded bone marrow biopsies (Kreft et al, 1997). DBA.44 appears to be a more sensitive marker of hairy cells than the traditional tartrate-resistant acid phosphatase (TRAP) activity which has long been a cornerstone in the diagnosis of hairy cell leukemia (Hoyer et al, 1997). Mantle zone lymphocytes and their corresponding lymphoma were DBA.44 and CD 44+, with a weaker reaction for CD w75 than marginal zone lymphocytes and monocytoid B-cells whereas monocytoid B cell lymphoma showed positivity for CD 74 and CD w75 with positivity for DBA.44 observed in only occasional cases. Hairy cell leukemias, in contrast, were all positive for DBA.44, with a weak reaction for CD 74 and a stronger positivity for CD w75 than either mantle cell lymphoma or monocytoid B-cell lymphoma specimens (Ohsawa et al, 1994).

Comments
While useful as a diagnostic marker, DBA.44 is not specific for hairy cells and should be used in a panel of antibodies to separate other B-cell lymphomas which may express the antigen.

References
•Al Saati T, Caspar S, Brousset P et al 1989. Production of anti-B monoclonal antibodies (DBB.42, DBA.44, DNA.7, and DND.53) reactive on paraffin-embedded tissues with a new B-lymphoma cell line grafted into athymic nude mice. Blood 74: 2476-2485.

•Cordone I, Annino L, Masi S et al 1995 Diagnostic relevance of peripheral blood immunocytochemistry in hairy cell leukaemia. Journal of Clinical Pathology 48: 955-960.

•Hounieu H, Chittal SM, Al Saati T, et al 1992. Hairy cell leukaemia. Diagnosis of bone marrow involvement in paraffin-embedded sections with monoclonal antibody DBA.44. American Journal of Clinical Pathology 98: 26-33. involvement in paraffin-embedded sections with monoclonal antibody DBA.44. American Journal of Clinical Pathology 98: 26-33.

•Hoyer JD, Li CYY-am LT et al 1997 Immunohistochemical demonstration of acid phosphatase isoenzyme 5 (tartrate-resistant in paraffin sections of hairy cell leukemia and other hematological disorders. American Journal of Clinical Pathology 108: 308-315.

•Kreft A, Busche G, Bernhards J, Georgii A 1977 Immunophenotype of hairy-cell leukaemia after cold polymerization of methyl-methacrylate embeddings from 50 diagnostic bone marrow biopsies. Histopathology 30: 145-151.

•Ohsawa M, Kanno H, Machii T, Aozasa K 1994 Immunoreactivity of neoplastic and non-neoplastic monocytoid B lymphocytes for DBA.44 and other antibodies. Journal of Clinical Pathology 47: 928-932.

•Wheaton S, Tallman MS, Hakimian D, Peterson L 1996. Minimal residual disease may predict bone marrow relapse in patients with hairy cell leukaemia treated with 2-chlorodeoxyadenosine. Blood 87: 1556-1560.

Bibliografía
Manual of diagnostic antibodies for immunohistology / Anthony S.-Y. Leong, Kumarasen Cooper, F. Joel W.-M. Leong.