title: Incidence and clinicobiologic characteristics of leukemic B-cell chronic lymphoproliferative disorders with more than one B-cell clone.
abstract: Leukemic B-chronic lymphoproliferative disorders (B-CLPDs) are generally believed to derive from a monoclonal B cell; biclonality has only occasionally been reported. In this study, we have explored the incidence of B-CLPD cases with 2 or more B-cell clones and established both the phenotypic differences between the coexisting clones and the clinicobiologic features of these patients. In total, 53 B-CLPD cases with 2 or more B-cell clones were studied. Presence of 2 or more B-cell clones was suspected by immunophenotype and confirmed by molecular/genetic techniques in leukemic samples (n = 42) and purified B-cell subpopulations (n = 10). Overall, 4.8% of 477 consecutive B-CLPDs had 2 or more B-cell clones, their incidence being especially higher among hairy cell leukemia (3 of 13), large cell lymphoma (2 of 10), and atypical chronic lymphocytic leukemia (CLL) (4 of 29). In most cases the 2 B-cell subsets displayed either different surface immunoglobulin (sIg) light chain (n = 37 of 53) or different levels of the same sIg (n = 9 of 53), usually associated with other phenotypic differences. Compared with monoclonal cases, B-CLL patients with 2 or more clones had lower white blood cell (WBC) and lymphocyte counts, more frequently displayed splenomegaly, and required early treatment. Among these, the cases in which a CLL clone coexisted with a non-CLL clone were older and more often displayed B symptoms, a monoclonal component, and diffuse infiltration of bone marrow and required early treatment more frequently than cases with monoclonal CLL or 2 CLL clones.
authors.affiliation: Servicio General de Citometria, Hospital Universitario de Salamanca, Paseo San Vicente, 58-182, 37007 Salamanca, Spain.
authors.forename: Maria-Luz
authors.initials: ML
authors.lastname: Sanchez
authors.forename: Julia
authors.initials: J
authors.lastname: Almeida
authors.forename: David
authors.initials: D
authors.lastname: Gonzalez
authors.forename: Marcos
authors.initials: M
authors.lastname: Gonzalez
authors.forename: Maria-Antonia
authors.initials: MA
authors.lastname: Garcia-Marcos
authors.forename: Ana
authors.initials: A
authors.lastname: Balanzategui
authors.forename: Maria-Consuelo
authors.initials: MC
authors.lastname: Lopez-Berges
authors.forename: Josep
authors.initials: J
authors.lastname: Nomdedeu
authors.forename: Teresa
authors.initials: T
authors.lastname: Vallespi
authors.forename: Marcos
authors.initials: M
authors.lastname: Barbon
authors.forename: Alejandro
authors.initials: A
authors.lastname: Martin
authors.forename: Pilar
authors.initials: P
authors.lastname: de la Fuente
authors.forename: Guillermo
authors.initials: G
authors.lastname: Martin-Nuñez
authors.forename: Javier
authors.initials: J
authors.lastname: Fernandez-Calvo
authors.forename: Jesus-Maria
authors.initials: JM
authors.lastname: Hernandez
authors.forename: Jesus F
authors.initials: JF
authors.lastname: San Miguel
authors.forename: Alberto
authors.initials: A
authors.lastname: Orfao
mesh_terms: D000911:Antibodies, Monoclonal / Q000378:metabolism; D001402:B-Lymphocytes / Q000166:cytology*; D015139:Blotting, Southern; D002999:Clone Cells; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D015448:Leukemia, B-Cell / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D008232:Lymphoproliferative Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D010641:Phenotype; D016133:Polymerase Chain Reaction; D013997:Time Factors
chemical_list: D000911:Antibodies, Monoclonal