Monoclonal B-cell lymphocytosis is closely related to chronic lymphocytic leukaemia and may be better classified as early-stage CLL.
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Monoclonal B-cell lymphocytosis is closely related to chronic lymphocytic leukaemia and may be better classified as early-stage CLL. / Kern, Wolfgang; Bacher, Ulrike; Haferlach, Claudia; Dicker, Frank; Alpermann, Tamara; Schnittger, Susanne; Haferlach, Torsten.
in: BRIT J HAEMATOL, Jahrgang 157, Nr. 1, 1, 2012, S. 86-96.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Monoclonal B-cell lymphocytosis is closely related to chronic lymphocytic leukaemia and may be better classified as early-stage CLL.
AU - Kern, Wolfgang
AU - Bacher, Ulrike
AU - Haferlach, Claudia
AU - Dicker, Frank
AU - Alpermann, Tamara
AU - Schnittger, Susanne
AU - Haferlach, Torsten
PY - 2012
Y1 - 2012
N2 - The World Health Organization classification uses a cut-off point of 5·0?×?10(9)/l cells with a chronic lymphocytic leukaemia (CLL)-phenotype in peripheral blood to discriminate between monoclonal B-lymphocytosis (MBL) and B-CLL. This study analysed 298 MBL patients by multi-parameter flow cytometry, chromosome banding analysis (CBA)/fluorescence in situ hybridization (FISH), and IGHV mutation status and compared them with 356 CLL patients. In MBL, CBA more frequently revealed a normal karyotype and FISH identified less frequently del(6q), del(13q) (as sole alterations), and del(17)(p13). Within the MBL cohort, a shorter time to treatment (TTT) was found for ZAP-70-positivity, 14q32/IGH-translocations (CBA), del(11)(q22·3) (FISH) and unmutated IGHV status. Higher CD38 and ZAP-70 expression, del(11)(q22·3) (FISH), trisomy 12 (FISH), and 14q32/IGH-translocations (CBA) were correlated with a shorter TTT in the combined cohort (MBL?+?CLL); a sole del(13)(q14) (FISH) correlated with longer TTT. Regarding overall survival, unmutated IGHV status and 'other' alterations (CBA) had an adverse impact. There was no correlation between the concentration of CLL-cells and TTT or overall survival. Multivariate analysis confirmed a negative impact on TTT for del(11)(q22·3)/ATM, trisomy 12 (both by FISH), and 14q32/IGH-translocations by CBA. These data emphasize a close relationship between MBL and CLL regarding clinically relevant parameters and provide no evidence to strictly separate these entities by a distinct threshold of clonal B-cells.
AB - The World Health Organization classification uses a cut-off point of 5·0?×?10(9)/l cells with a chronic lymphocytic leukaemia (CLL)-phenotype in peripheral blood to discriminate between monoclonal B-lymphocytosis (MBL) and B-CLL. This study analysed 298 MBL patients by multi-parameter flow cytometry, chromosome banding analysis (CBA)/fluorescence in situ hybridization (FISH), and IGHV mutation status and compared them with 356 CLL patients. In MBL, CBA more frequently revealed a normal karyotype and FISH identified less frequently del(6q), del(13q) (as sole alterations), and del(17)(p13). Within the MBL cohort, a shorter time to treatment (TTT) was found for ZAP-70-positivity, 14q32/IGH-translocations (CBA), del(11)(q22·3) (FISH) and unmutated IGHV status. Higher CD38 and ZAP-70 expression, del(11)(q22·3) (FISH), trisomy 12 (FISH), and 14q32/IGH-translocations (CBA) were correlated with a shorter TTT in the combined cohort (MBL?+?CLL); a sole del(13)(q14) (FISH) correlated with longer TTT. Regarding overall survival, unmutated IGHV status and 'other' alterations (CBA) had an adverse impact. There was no correlation between the concentration of CLL-cells and TTT or overall survival. Multivariate analysis confirmed a negative impact on TTT for del(11)(q22·3)/ATM, trisomy 12 (both by FISH), and 14q32/IGH-translocations by CBA. These data emphasize a close relationship between MBL and CLL regarding clinically relevant parameters and provide no evidence to strictly separate these entities by a distinct threshold of clonal B-cells.
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Aged, 80 and over
KW - Prospective Studies
KW - Survival Rate
KW - Disease-Free Survival
KW - Chromosome Aberrations
KW - Flow Cytometry
KW - In Situ Hybridization, Fluorescence
KW - World Health Organization
KW - Chromosome Banding
KW - Chromosomes, Human/genetics
KW - Immunoglobulin Heavy Chains/genetics
KW - B-Lymphocytes
KW - Leukemia, Lymphocytic, Chronic, B-Cell/classification/diagnosis/genetics/mortality
KW - Lymphocytosis/classification/diagnosis/genetics/mortality
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Aged, 80 and over
KW - Prospective Studies
KW - Survival Rate
KW - Disease-Free Survival
KW - Chromosome Aberrations
KW - Flow Cytometry
KW - In Situ Hybridization, Fluorescence
KW - World Health Organization
KW - Chromosome Banding
KW - Chromosomes, Human/genetics
KW - Immunoglobulin Heavy Chains/genetics
KW - B-Lymphocytes
KW - Leukemia, Lymphocytic, Chronic, B-Cell/classification/diagnosis/genetics/mortality
KW - Lymphocytosis/classification/diagnosis/genetics/mortality
M3 - SCORING: Journal article
VL - 157
SP - 86
EP - 96
JO - BRIT J HAEMATOL
JF - BRIT J HAEMATOL
SN - 0007-1048
IS - 1
M1 - 1
ER -
