Mature B-cell leukemias with more than 55% prolymphocytes. A heterogeneous group that includes an unusual variant of mantle cell lymphoma.
We studied 20 cases of mature B-cell leukemia with more than 55% prolymphocytes in peripheral blood or bone marrow, fulfilling the French-American-British criteria for B-cell prolymphocytic leukemia (PLL). Cases segregated into 3 groups: de novo PLL, 6; PLL occurring in patients with a previous well-established diagnosis of chronic lymphocytic leukemia (PLL-HxCLL), 10; and t(11;14)(q13;q32)-positive neoplasms, 4. All cases expressed monotypic immunoglobulin light chain, and most were positive for CD5. All t(11;14)-positive neoplasms were CD23- and uniquely positive for cyclin D1. Cytogenetic abnormalities were present in 19; in all 19, the karyotype was complex, indicating clonal evolution and genomic instability. The most frequent cytogenetic abnormality in de novo PLL involved chromosome 7 in 4 cases. Trisomy 12 or add(12p) was present in 4 cases of PLL-HxCLL. We conclude that mature B-cell leukemias with more than 55% prolymphocytes are a heterogeneous group that includes t(11;14)-positive neoplasms, which we suggest are best classified as mantle cell lymphoma. We also suggest that prolymphocytic morphologic features are a common end-stage of transformation for several B-cell neoplasms.
Schlette
E
E
Department of Hematopathology, University of Texas M.D. Anderson Cancer Center, Houston, USA.
Bueso-Ramos
C
C
Giles
F
F
Glassman
A
A
Hayes
K
K
Medeiros
L J
LJ
D000368:Aged; D000369:Aged, 80 and over; D001854:Bone Marrow Cells / Q000473:pathology; D018956:CD5 Antigens / Q000032:analysis; D002469:Cell Separation; D002880:Chromosomes, Human, Pair 11; D002882:Chromosomes, Human, Pair 13; D002897:Chromosomes, Human, Pair 7; D019938:Cyclin D1 / Q000032:analysis; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D015448:Leukemia, B-Cell / Q000473:pathology*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics / Q000473:pathology; D008214:Lymphocytes / Q000473:pathology*; D020522:Lymphoma, Mantle-Cell / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017455:Receptors, IgE / Q000032:analysis; D014314:Trisomy / Q000473:pathology
D018956:CD5 Antigens; D017455:Receptors, IgE; D019938:Cyclin D1