title: Detection of non-CLL-like monoclonal B cell lymphocytosis increases dramatically in the very elderly, while detection of CLL-like populations varies by race: findings in a multiethnic population-based cohort of elderly women.
abstract: Monoclonal B cell lymphocytosis (MBL) is both a marker of immune senescence and a potential precursor of B cell malignancy. Most MBL populations have a chronic lymphocytic leukemia-like (CLL-like) immunophenotype, but those that are CD5-negative (non-CLL-like) are also recognized and may represent a distinct diagnostic entity. To date, MBL studies have taken place in relatively homogenous populations, although risk of CLL varies across racial groups and geographic regions. We report flow cytometry data from 597 ethnically diverse 64-94-year-old women from across the USA who are participants in the Women's Health Initiative (WHI) Long-Life Study (LLS). Overall, MBL was detected in 26 % of the participants and included 20.9 % with a CLL-like immunophenotype, 5 % with a non-CLL-like immunophenotype, and 1.3 % with both. White and Hispanic women were more than twice as likely to have a CLL-like MBL population detected than African American women, corrected for age (P = 0.003). By contrast, detection of non-CLL-like MBL did not vary significantly by race, but did increase markedly with advancing age, being present in 12.7 % of those aged 85 and older. We provide new evidence that rates of detection of CLL-like MBL are lower in African Americans, and further suggest that non-CLL-like clonal expansions should be regarded as distinct from CLL-like MBL.
authors.affiliation: Department of Laboratory Medicine, University of Washington Medical Center, Seattle, WA, USA. edlefsen@u.washington.edu.
authors.forename: Kerstin L
authors.initials: KL
authors.lastname: Edlefsen
authors.affiliation: Department of Laboratory Medicine, University of Washington Medical Center, Seattle, WA, USA.
authors.forename: Sindhu
authors.initials: S
authors.lastname: Cherian
authors.affiliation: Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA.
authors.forename: Anneclaire J
authors.initials: AJ
authors.lastname: De Roos
authors.affiliation: MedStar Health Research Institute, Hyattsville, MD, USA.
authors.forename: Asqual
authors.initials: A
authors.lastname: Getaneh
authors.affiliation: Washington Cancer Institute at Medstar Washington Hospital Center, Washington, DC, USA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lessin
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worcester, MA, UK.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Laboratory Medicine, University of Washington Medical Center, Seattle, WA, USA.
authors.forename: Brent L
authors.initials: BL
authors.lastname: Wood
authors.affiliation: Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.|Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Alexander P
authors.initials: AP
authors.lastname: Reiner
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000944:Antigens, Differentiation, B-Lymphocyte / Q000032:analysis; D016175:B-Lymphocyte Subsets / Q000276:immunology*; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D005260:Female; D005434:Flow Cytometry; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016130:Immunophenotyping; D008875:Middle Aged; D064887:Observational Studies as Topic; D010265:Paraproteinemias / Q000453:epidemiology* / Q000208:ethnology; D017698:Postmenopause; D012494:Sampling Studies; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data
chemical_list: D000944:Antigens, Differentiation, B-Lymphocyte
keywords: Chronic lymphocytic leukemia (CLL); Elderly; Monoclonal B cell lymphocytosis (MBL); Race; Women