Incidence and clinicobiologic characteristics of leukemic B-cell chronic lymphoproliferative disorders with more than one B-cell clone.
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.
Sanchez
Maria-Luz
ML
Servicio General de Citometria, Hospital Universitario de Salamanca, Paseo San Vicente, 58-182, 37007 Salamanca, Spain.
Almeida
Julia
J
Gonzalez
David
D
Gonzalez
Marcos
M
Garcia-Marcos
Maria-Antonia
MA
Balanzategui
Ana
A
Lopez-Berges
Maria-Consuelo
MC
Nomdedeu
Josep
J
Vallespi
Teresa
T
Barbon
Marcos
M
Martin
Alejandro
A
de la Fuente
Pilar
P
Martin-Nuñez
Guillermo
G
Fernandez-Calvo
Javier
J
Hernandez
Jesus-Maria
JM
San Miguel
Jesus F
JF
Orfao
Alberto
A
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
D000911:Antibodies, Monoclonal