Monoclonal B-cell lymphocytosis
a brief review for general clinicians
Keywords:
B-Lymphocytes, Leukemia, lymphocytic, chronic, B-cell, Flow cytometry, Epidemiology, Disease managementAbstract
Monoclonal B-cell lymphocytosis (MBL) is a recently described medical condition that displays biological similarities to the most common subtype of adult leukemia in the Western world, i.e. chronic lymphocytic leukemia (CLL). Diagnostic criteria have been published with the aim of differentiating between these two entities. The overall prevalence of MBL is at least 100 times higher than that of CLL, which indirectly suggests that MBL is not necessarily a pre-leukemic condition, although in some circumstances, CLL cases can really be preceded by MBL. In view of this high prevalence rate, general clinicians and even non-hematological specialists have a high chance of being faced with individuals with MBL in their routine clinical practice. MBL is classified as “clinical MBL”, “population-screening MBL” and “atypical MBL” and the clinical management of affected individuals depends greatly on this differentiation. The present review provides a guide to diagnosing and following up MBL patients.
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References
Redaelli A, Laskin BL, Stephens JM, Botteman MF, Pashos CL. The clinical and epidemio- logical burden of chronic lymphocytic leukaemia. Eur J Cancer Care (Engl). 2004;13(3): 279-87.
Vogt RF, Shim YK, Middleton DC, et al. Monoclonal B-cell lymphocytosis as a biomarker in environmental health studies. Br J Haematol. 2007;139(5):690-700.
Marti G, Abbasi F, Raveche E, et al. Overview of monoclonal B-cell lymphocytosis. Br J Hae- matol. 2007;139(5):701-8.
Marti GE, Rawstron AC, Ghia P, et al. Diagnostic criteria for monoclonal B-cell lymphocytosis. Br J Haematol. 2005;130(3):325-32.
Ghia P, Prato G, Stella S, et al. Age-dependent accumulation of monoclonal CD4+ CD8+ double positive T lymphocytes in the peripheral blood of the elderly. Br J Haematol. 2007;139(5):780-90.
Rawstron AC, Green MJ, Kuzmicki A, et al. Monoclonal B lymphocytes with the characteristics of “indolent” chronic lymphocytic leukemia are present in 3.5% of adults with normal blood counts. Blood. 2002;100(2):635-9.
Ghia P, Prato G, Scielzo C, et al. Monoclonal CD5+ and CD5- B-lymphocyte expansions are frequent in the peripheral blood of the elderly. Blood. 2004;103(6):2337-42.
Dagklis A, Fazi C, Sala C, et al. The immunoglobulin gene repertoire of low-count chronic lym- phocytic leukemia (CLL)-like monoclonal B lymphocytosis is different from CLL: diagnostic implications for clinical monitoring. Blood. 2009;114(1):26-32.
Rachel JM, Zucker ML, Fox CM, et al. Monoclonal B-cell lymphocytosis in blood donors. Br J Haematol. 2007;139(5): 832-6.
Nieto WG, Almeida J, Romero A, et al. Increased frequency (12%) of circulating chronic lym- phocytic leukemia-like B-cell clones in healthy subjects using a highly sensitive multicolor flow cytometry approach. Blood. 2009;114(1):33-7.
Caporaso N, Goldin L, Plass C, et al. Chronic lymphocytic leukaemia genetics overview. Br J Haematol. 2007;139(5):630-4.
Rawstron AC, Yuille MR, Fuller J, et al. Inherited predisposition to CLL is detectable as sub- clinical monoclonal B-lymphocytes expansion. Blood. 2002;100(7):2289-90.
Marti GE, Carter P, Abbasi F, et al. B-cell monoclonal lymphocytosis and B-cell abnormali- ties in the setting of familial B-cell chronic lymphocytic leukemia. Cytometry B Clin Cytom. 2003;52(1):1-12.
Matos DM, Ismael SJ, Scrideli CA, et al. Monoclonal B-cell lymphocytosis in first-degree rela- tives of patients with sporadic (non-familial) chronic lymphocytic leukaemia. Br J Haematol. 2009;147(3):339-46.
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):512-20.
Rawstron AC, Bennett F, Hillmen P. The biological and clinical relationship between CD5+23+ monoclonal B-cell lymphocytosis and chronic lymphocytic leukaemia. Br J Haematol. 2007;139(5):724-9.
Rossi D, Sozzi E, Puma A, et al. The prognosis of clinical monoclonal B cell lymphocytosis differs from prognosis of Rai 0 chronic lymphocytic leukaemia and is recapitulated by bio- logical risk factors. Br J Haematol. 2009;146(1):64-75.
Rawstron AC, Bennett FL, O’Connor SJ, et al. Monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia. N Engl J Med. 2008;359(6):575-83.
Lanasa MC, Allgood SD, Volkheimer AD, et al. Single-cell analysis reveals oligoclonality among ‘low count’ monoclonal B-cell lymphocytosis. Leukemia. 2010;24(1):133-40.
Shanafelt TD, Kay NE, Jenkins G, et al. B-cell count and survival: differentiating chronic lymphocytic leukemia from monoclonal B-cell lymphocytosis based on clinical outcome. Blood. 2009;113(18):4188-96.
