B-cell count and survival: differentiating chronic lymphocytic leukemia from monoclonal B-cell lymphocytosis based on clinical outcome

Shanafelt, Tait D.; Kay, Neil E.; Jenkins, G. Douglas; Call, Timothy G.; Zent, Clive S.; Jelinek, Diane F.; Morice, William G.; Boysen, Justin C.; Zakko, Liam; Schwager, Susan M.; Slager, Susan L.; Hanson, Curtis A.

doi:10.1182/blood-2008-09-176149

Cited by 112 publications

(113 citation statements)

References 35 publications

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“…The B cell count is a continuous variable, and the best thresholds vary around 10-11 ϫ 10 9 /L in different studies. 12,13 An additional issue is the definition of SLL, that is, lymph node or other tissue involvement by an infiltrate characteristic of CLL but without the requisite number of PB monoclonal B cells for a diagnosis of CLL. Similarly to PB, small clonal populations of CLL-type B cells may be detected in lymph nodes removed for the diagnosis of other conditions; minimal criteria for the diagnosis of SLL on tissue biopsy specimens may need to be developed if overdiagnosis is to be avoided.…”

Section: Chronic Lymphocytic Leukemiamentioning

confidence: 99%

The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications

Campo

Swerdlow

Harris

et al. 2011

Blood

1,782

1,414

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The World Health Organization classification of lymphoid neoplasms updated in 2008 represents a worldwide consensus on the diagnosis of these tumors and is based on the recognition of distinct diseases, using a multidisciplinary approach. The updated classification refined the definitions of well-recognized diseases, identified new entities and variants, and incorporated emerging concepts in the understanding of lymphoid neoplasms. However, some questions were unresolved, such as the extent to which specific genetic or molecular alterations define certain tumors, and the status of provisional entities, categories for which the World Health Organization working groups felt there was insufficient evidence to recognize as distinct diseases at this time. In addition, since its publication, new findings and ideas have been generated. This review summarizes the scientific rationale for the classification, emphasizing changes that have had an effect on practice guidelines. The authors address the criteria and significance of early or precursor lesions and the identification of certain lymphoid neoplasms largely associated with particular age groups, such as children and the elderly. The issue of borderline categories having overlapping features with large B-cell lymphomas, as well as several provisional entities, is reviewed. These new observations chart a course for future research in the field. (Blood. 2011

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Section: Chronic Lymphocytic Leukemiamentioning

confidence: 99%

The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications

Campo

Swerdlow

Harris

et al. 2011

Blood

1,782

1,414

View full text Add to dashboard Cite

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“…Individuals with this condition have a low risk, typically 1% per year, of developing progressive disease that requires treatment (5). The risk is significantly lower than for individuals with Rai stage 0 CLL (6). Prognostic factors such as IGHV mutation status, chromosomal abnormalities, CD38, and ZAP-70 expression, which are associated with a poor prognosis in CLL, may also be predictive of outcome in CLL-type MBL but there are relatively few cases with poor-risk prognostic factors and prognostication is not straightforward (5)(6)(7)(8).…”

mentioning

confidence: 99%

Chronic lymphocytic leukaemia (CLL) and CLL‐type monoclonal B‐cell lymphocytosis (MBL) show differential expression of molecules involved in lymphoid tissue homing

Rawstron¹,

Shingles²,

Tute³

et al. 2010

Cytometry Part B Clinical

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Introduction: The aim of this study was to screen for cell surface markers that could discriminate CLLtype MBL from CLL or identify CLL cases likely to have stable disease.Methods: Six color flow cytometry was performed on CLL-type MBL (n 5 94) and CLL (n 5 387) at diagnosis or relapse; 39 cases had poor-risk chromosomal abnormalities (17p and/or 11q deletion). Expression of 30 markers was analysed: CCR6, CD10, CD103, CD11c, CD138, CD200, CD22, CD23, CD24, CD25, CD27, CD31, CD38, CD39, CD43, CD49d, CD5, CD52, CD62L, CD63, CD79b, CD81, CD86, CD95, CXCR5, HLADR, IgD, IgG, IgM, LAIR1.Results: There was no difference in expression between CLL-type MBL and CLL for the majority of markers. Differential expression was observed for several markers, mainly between MBL and CLL cases with adverse-risk chromosomal abnormalities. These differences included lower expression of CD38 (9.4-fold lower, P 5 0.007) and CD49d (3.2-fold lower, P 5 0.008) and higher expression of LAIR-1 (3.7-fold higher, P 5 0.003), CXCR5 (1.25-fold higher, P 5 0.002), and CCR6 (1.9-fold higher P < 0.001) on CLL-type MBL compared to CLL with adverse chromosomal abnormalities. CD62L (L-selectin) which mediates lymphocyte adhesion to endothelial venules of lymphoid tissue, was expressed at a significantly different level between CLL-type MBL and both CLL sub-groups, with 1.3-fold lower (P 5 0.04) expression levels on the MBL cases. However, there was broad overlap in expression levels.Conclusions: CLL-type MBL is phenotypically identical to CLL for a very broad range of markers. Differential expression is predominantly related to known prognostic markers and proteins involved in homing to lymphoid tissue.

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“…These studies have generally suggested that a higher cutoff, perhaps as high as 10-11 Â 10 9 , may be more useful for the distinction between MBL and CLL. [52][53][54] This remains an area of controversy that will likely be addressed in future revisions of the WHO classification. In addition, there are currently no accepted criteria for distinction between MBL and CLL/SLL based on the extent of bone marrow involvement alone.…”

Section: Precursor Lesion-monoclonal B Lymphocytosismentioning

confidence: 99%

Nodal and leukemic small B-cell neoplasms

Cook

2013

Modern Pathology

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The small B-cell neoplasms represent some of the most frequently encountered lymphoproliferative disorders in routine surgical pathology practice. This report reviews the current diagnostic criteria for classifying small B-cell neoplasms and distinguishing them from newly recognized precursor conditions that do not appear to represent overt lymphomas. Newly available immunohistochemical stains and molecular studies that may assist in the diagnosis and classification of these neoplasms are also discussed.

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B-cell count and survival: differentiating chronic lymphocytic leukemia from monoclonal B-cell lymphocytosis based on clinical outcome

Cited by 112 publications

References 35 publications

The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications

The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications

Chronic lymphocytic leukaemia (CLL) and CLL‐type monoclonal B‐cell lymphocytosis (MBL) show differential expression of molecules involved in lymphoid tissue homing

Nodal and leukemic small B-cell neoplasms

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