title: Chronic lymphocytic leukemia/small lymphocytic lymphoma associated with IgM paraprotein.
abstract: We studied the clinicopathologic, immunophenotypic, and cytogenetic features of 26 patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) associated with serum IgM paraprotein. The study group (16 men; 10 women; median age, 64 years; range, 40-82 years) represents approximately 2.5% of CLL/SLL cases at our institution. The paraprotein level ranged from 1 to 14 g/L (median, 4 g/L). Neoplasms in bone marrow were composed of small round lymphocytes arranged in nodular (n = 6), diffuse (n = 5), interstitial (n = 5), or mixed (n = 10) patterns. All cases were positive for monotypic surface immunoglobulin light chain, IgM/IgD, CD5, CD19, CD20, and CD23. CD11c (14/20 [70%]), CD79b (11/19 [58%]), FMC-7 (11/26 [42%]), CD22 (8/20 [40%]), and ZAP-70 (6/19 [32%]) were expressed in subsets of cases. Of 17 bone marrow specimens assessed by conventional cytogenetics, 6 were abnormal and 11 were diploid. The overall survival of this group (median follow-up, 24 months) was not significantly different from that for an age-, sex-and stage-matched group of 52 CLL/SLL patients without IgM paraprotein (P = .60). We conclude that CLL/SLL cases with serum IgM paraprotein are similar to other CLL/SLL cases in their clinicopathologic and immunophenotypic features.
authors.affiliation: Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
authors.forename: C Cameron
authors.initials: CC
authors.lastname: Yin
authors.forename: Pei
authors.initials: P
authors.lastname: Lin
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Carney
authors.forename: Beverly C
authors.initials: BC
authors.lastname: Handy
authors.forename: George Z
authors.initials: GZ
authors.lastname: Rassidakis
authors.forename: Joan H
authors.initials: JH
authors.lastname: Admirand
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Keating
authors.forename: L Jeffrey
authors.initials: LJ
authors.lastname: Medeiros
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001797:Blood Protein Electrophoresis; D001853:Bone Marrow / Q000473:pathology; D002869:Chromosome Aberrations; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology*; D007150:Immunohistochemistry; D016130:Immunophenotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010266:Paraproteins / Q000276:immunology*; D011505:Protein-Tyrosine Kinases / Q000378:metabolism; D051746:ZAP-70 Protein-Tyrosine Kinase
chemical_list: D007075:Immunoglobulin M; D010266:Paraproteins; D011505:Protein-Tyrosine Kinases; D051746:ZAP-70 Protein-Tyrosine Kinase; C497261:ZAP70 protein, human