Please use this identifier to cite or link to this item:
http://hdl.handle.net/1942/28606
Title: | Lymphoma-like monoclonal B cell lymphocytosis in a patient population: biology, natural evolution, and differences from CLL-like clones | Authors: | Vander Meeren, Sam Heyrman, Bert Renmans, Wim Bakkus, Marleen MAES, Brigitte De Raeve, Hendrik Schots, Rik Jochmans, Kristin |
Issue Date: | 2018 | Publisher: | SPRINGER | Source: | ANNALS OF HEMATOLOGY, 97(7), p. 1219-1227 | Abstract: | High-count monoclonal B cell lymphocytosis (MBL) with a chronic lymphocytic leukemia (CLL) phenotype is a well-known entity, featuring 1-4% annual risk of progression towards CLL requiring treatment. Lymphoma-like MBL (L-MBL), on the other hand, remains poorly defined and data regarding outcome are lacking. We retrospectively evaluated 33 L-MBL cases within our hospital population and compared them to 95 subjects with CLL-like MBL (C-MBL). Diagnoses of L-MBL were based on asymptomatic B cell clones with Matutes score < 3, B cells < 5.0 x 10(3)/mu l, and negative computerized tomography scans. We found that median B cell counts were considerably lower compared to C-MBL (0.6 vs 2.3 x 10(3)/mu l) and remained stable over time. Based on immunophenotyping and immunogenetic profiling, most L-MBL clones did not correspond to known lymphoma entities. A strikingly high occurrence of paraproteinemia (48%), hypogammaglobulinemia (45%), and biclonality (21%) was seen; these incidences being significantly higher than in C-MBL (17, 21, and 5%, respectively). Unrelated monoclonal gammopathy of undetermined significance was a frequent feature, as the light chain type of 5/12 paraproteins detected was different from the clonal surface immunoglobulin. After 46-month median follow-up, 2/24 patients (8%) had progressed towards indolent lymphoma requiring no treatment. In contrast, 41% of C-MBL cases evolved to CLL and 17% required treatment. We conclude that clinical L-MBL is characterized by pronounced immune dysregulation and very slow or absent progression, clearly separating it from its CLL-like counterpart. | Notes: | [Vander Meeren, Sam; Renmans, Wim; Bakkus, Marleen; Jochmans, Kristin] Vrije Univ Brussel, Univ Ziekenhuis Brussel, Div Hematol, Dept Biol Clin, Brussels, Belgium. [Heyrman, Bert] ZNA Middelheim, Div Hematol, Dept Internal Med, Antwerp, Belgium. [Maes, Brigitte] Jessa Ziekenhuis, Div Hematol, Dept Clin Biol, Hasselt, Belgium. [De Raeve, Hendrik] Vrije Univ Brussel, Univ Ziekenhuis Brussel, Dept Pathol, Brussels, Belgium. [Schots, Rik] Vrije Univ Brussel, Univ Ziekenhuis Brussel, Div Hematol, Dept Internal Med, Brussels, Belgium. | Keywords: | Monoclonal B cell lymphocytosis; Chronic lymphocytic leukemia; Non-Hodgkin's lymphoma; MGUS; Immunophenotyping | Document URI: | http://hdl.handle.net/1942/28606 | ISSN: | 0939-5555 | e-ISSN: | 1432-0584 | DOI: | 10.1007/s00277-018-3282-0 | ISI #: | 000433502600007 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
VanderMeeren2018_Article_Lymphoma-likeMonoclonalBCellLy.pdf Restricted Access | Published version | 666.3 kB | Adobe PDF | View/Open Request a copy |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.