Frequency of monoclonal B-cell lymphocytosis in relatives of patients with chronic lymphocytic leukemia
Abstract
Introduction:Monoclonal B-cell lymphocytosis is a symptom free condition characterized by the circulation of small clonal population of B lymphocytes in peripheral blood (less than 5x109/L) expressing an immunophenotype similar to chronic lymphocytic leukemia. Different studies based on big hospital series have manifested a higher risk in subjects with monoclonal B-cell lymphocytosis to progress to a chronic lymphocytic leukemia. The behavior of this hematologic entity is unknown therefore its frequency in sporadic chronic lymphocytic leukemia patient relatives was determined.
Methods:Transversal descriptive study, 8 color flow cytometry was performed using two of the tubes of the Euro Flow recommended panel, with modifications, for the diagnose of chronic lymphoproliferative disorders of B lymphocytes; besides, a fluorescence in situ hybridization was performed. univariate and bivariate analyses of the information were performed.
Results:Monoclonal B-cell lymphocytosis frequency found in 51 analyzed relatives was 2%, it was a female participant, 59 years old, with a total leukocyte count of 7.7x109/L and a B lymphocyte count of 0.124x109/L; from these, 0.04x109/L were clonal cells with restrictions of the kappa light chain. Rearrangements of the IGH gene (14q32) were found.
Conclusion:Monoclonal B-cell lymphocytosis was detected in one relative of a patient with sporadic chronic lymphocytic leukemia in a frequency similar to the one reported in general population.
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Keywords
- Monoclonal B-cell lymphocytosis
- chronic lymphocytic leukemia
- B cells
- flow cytometry
References
Vaughan AT, Roghanian A, Cragg MS. B cells-Masters of the immunoverse. Int J Biochem Cell Biol. 2011;43(3):280–285.
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th. Lyon, France: WHO; 2008.
Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Dohner H, et al. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines. Blood. 2008;111(12):5446–5456.
Zhang S, Kipps TJ. The pathogenesis of chronic lymphocytic leukemia. Annu Rev Pathol. 2014;9:103–118.
Okaly GVP , Nargund AR , Venkataswamy E , Jayanna PK , Juvva CR , Prabhudesai S. Chronic lymphoproliferative disorders at an Indian tertiary cancer centre - the panel sufficiency in the diagnosis of chronic lymphocytic leukaemia. J Clin Diagn Res. 2013;7(7):1366–1367.
Goldin LR, Slager SL, Caporaso NE. Familial chronic lymphocytic leukemia. Curr Opin Hematol. 2010;17(4):350–355.
Goldin LR, Pfeiffer RM, Li X, Hemminki K. Familial risk of lymphoproliferative tumors in families of patients with chronic lymphocytic leukemia: results from the Swedish Family-Cancer Database. Blood. 2004;104(6):1850–1854.
Marti GE, Rawstron AC, Ghia P, Hillmen P, Houlston RS, Kay N, et al. Diagnostic criteria for monoclonal B-cell lymphocytosis. Br J Haematol. 2005;130(3):325–332.
Fazi C, Scarfo L, Pecciarini L, Cottini F, Dagklis A, Janus A, et al. General population low-count CLL-like MBL persists over time without clinical progression, although carrying the same cytogenetic abnormalities of CLL. Blood. 2011;118(25):6618–6625.
Crowther-Swanepoel D, Corre T, Lloyd A, Gaidano G, Olver B, Bennett FL, et al. Inherited genetic susceptibility to monoclonal B-cell lymphocytosis. Blood. 2010;116(26):5957–5960.
Shim YK, Middleton DC, Caporaso NE, Rachel JM, Landgren O, Abbasi F, et al. Prevalence of monoclonal B-cell lymphocytosis: a systematic review. Cytometry B Clin Cytom. 2010;78(1):S10–S18.
Rachel JM, Zucker ML, Fox CM, Plapp FV, Menitove JE, Abbasi F, et al. Monoclonal B-cell lymphocytosis in blood donors. Br J Haematol. 2007;139(5):832–836.
Ghia P, Prato G, Scielzo C, Stella S, Geuna M, Guida G, et al. Monoclonal CD5+ and CD5- B lymphocyte expansions are frequent in the peripheral blood of the elderly. Blood. 2004;103(6):2337–2342.
Rawstron AC, Green MJ, Kuzmicki A, Kennedy B, Fenton JA, Evans PA, et al. Monoclonal B lymphocytes with the characteristics of "indolent" chronic lymphocytic leukemia are present in 35% of adults with normal blood counts. Blood. 2002;100(2):635–639.
Nieto WG, Almeida J, Romero A, Teodosio C, Lopez A, Henriques AF, et al. Increased frequency (12%) of circulating chronic lymphocytic leukemia-like B-cell clones in healthy subjects using a highly sensitive multicolor flow cytometry approach. Blood. 2009;114(1):33–37.
Rawstron AC, Yuille MR, Fuller J, Cullen M, Kennedy B, Richards S, et al. Inherited predisposition to CLL is detectable as subclinical monoclonal B-lymphocyte expansion. Blood. 2002;100(7):2289–2290.
Lanasa MC, Weinberg JB. Immunologic aspects of monoclonal B-cell lymphocytosis. Immunol Res. 2011;49(1-3):269–280.
Rawstron AC, Bennett FL, O'Connor SJM, Kwok M, Fenton JAL, Plummer M, et al. Monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia. New Engl J Med. 2008;359(6):575–583.
Landgren O, Albitar M, Ma W, Abbasi F, Hayes RB, Ghia P, et al. B-cell clones as early markers for chronic lymphocytic leukemia. N Engl J Med. 2009;360(7):659–667.
Brome BMR, Galeano ALM, Cifuentes IMG. Cáncer. Secretaría Seccional de Salud y Protección Social, Gobernación de Antioquia. Estadísticas vitales, capítulo 3: Estructura de la morbilidad en el departamento de Antioquia; 2010.
https://www.dssa.gov.co/index.php/descargas/250-capituloestructura/file
Ospina RCM, Holguin VHO, Castañeda NAM, Marin PDM, Jaimes BM, Cadavid ME. Capítulo 4: Mortalidad. Secretaría Seccional de Salud y Protección Social, Gobernación de Antioquia. Estadísticas vitales; 2010. https://www.dssa.gov.co/index.php/descargas/251-capituloestructuramortalidad/file
D´Arena G, Musto P. Monoclonal B-cell lymphocytosis. Transl Med UniSa. 2014;8:75–79.
van Dongen JJ, Lhermitte L, Bottcher S, Almeida J, van der Velden VH, Flores-Montero J, et al. EuroFlow antibody panels for standardized n-dimensional flow cytometric immunophenotyping of normal, reactive and malignant leukocytes. Leukemia. 2012;26(9):1908–1975.
Smolewski P, Witkowska M, Korycka-Wolowiec A. New insights into biology, prognostic factors, and current therapeutic strategies in chronic lymphocytic leukemia. ISRN Oncol. 2013;2013:740615–740615.
Puiggros A, Blanco G, Espinet B. Genetic abnormalities in chronic lymphocytic leukemia: where we are and where we go. BioMed Research International. 2014;2014:435983–435983.
Marti GE, Carter P, Abbasi F, Washington GC, Jain N, Zenger VE, et al. B-Cell Monoclonal Lymphocytosis and B-Cell Abnormalities in the Setting of familial B-Cell Chronic Lymphocytic Leukemia. Cytometry B Clin Cytom. 2003;52(1):1–12.
Lanasa MC, Allgood SD, Slager SL, Dave SS, Love C, Marti GE, et al. Immunophenotypic and gene expression analysis of monoclonal B-cell lymphocytosis shows biologic characteristics associated with good prognosis CLL. Leukemia. 2011;25(9):1459–1466.
Goldin LR, Lanasa MC, Slager SL, Cerhan JR, Vachon CM, Strom SS, et al. Common occurrence of monoclonal B-cell lymphocytosis among members of high-risk CLL families. Br J Haematol. 2010;151(2):152–158.
Shanshal M, Haddad RY. Chronic lymphocytic leukemia. Dis Mon. 2012;58(4):153–167.
Villegas R, Jaramillo P, Cardona J. Prevalencia de linfocitosis monoclonal de células b y factores asociados: metaanálisis 2002-2012. Rev Cubana Hematol Inmunol Hemoter. 2015;31(2):172–186.
Scarfo L, Fazi C, Ghia P. MBL Versus CLL. How Important Is the Distinction? Hematol Oncol Clin North Am. 2013;27(2):251–265.
Vardi A, Dagklis A, Scarfo L, Jelinek D, Newton D, Bennett F, et al. Immunogenetics shows that not all MBL are equal: the larger the clone, the more similar to CLL. Blood. 2013;121(22):4521–4528.
Hoffman R, Benz EJ Jr, Shattil SJ, Furie B, Silberstein LE, McGlave P, et al. Hematology. 5th. Philadelphia: Churchill livingstone Elsevier; 2009.
Henriques A, Rodriguez-Caballero A, Criado I, Langerak AW, Nieto WG, Lecrevisse Q, et al. Molecular and cytogenetic characterization of expanded B-cell clones from multiclonal versus monoclonal B-cell chronic lymphoproliferative disorders. Haematologica. 2014;99(5):897–907.
Henriques A, Rodriguez-Caballero A, Nieto WG, Langerak AW, Criado I, Lecrevisse Q, et al. Combined patterns of IGHV repertoire and cytogenetic/molecular alterations in monoclonal B lymphocytosis versus chronic lymphocytic leukemia. PLoS One. 2013;8(7):e67751. [PubMed]
Karube K, Scarfò L, Campo E, Ghia P. Monoclonal B cell lymphocytosis and "in situ" lymphoma. Semin Cancer Biol. 2014;24:3–14.
Kern W, Haferlach C, Dicker F, Schnittger S, Haferlach T. Monoclonal B-cell lymphocytosis (MBL) is closely related to chronic lymphocytic Leukemia (CLL) and may be better classified as early-stage CLL. Br J Haematol. 2012;157(1):86–96.
Kern W, Haferlach C, Dicker F, Schnittger S, Haferlach T. Genetic and clinical relation between monoclonal B-cell lymphocytosis (MBL) and chronic lymphocytic leukemia (CLL) Onkologie. 2010;33(6):20–21.
Lanasa MC, Allgood SD, Volkheimer AD, Gockerman JP, Whitesides JF, Goodman BK, et al. Single-cell analysis reveals oligoclonality among low-count monoclonal B-cell lymphocytosis. Leukemia. 2010;24(1):133–140.
Shanafelt TD, Ghia P, Lanasa MC, Landgren O, Rawstron AC. Monoclonal B-cell lymphocytosis (MBL): biology, natural history and clinical management. Leukemia. 2010;24(3):512–520.
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