Intravascular bone marrow accumulation in persistent polyclonal lymphocytosis: a misleading feature for B-cell neoplasm

Feugier, Pierre; March, Anne Kennel De; Lesesve, J.‐F.; Monhoven, Nathalie; Dorvaux, Véronique; Braun, Françoise; Gregoire, M.; Jonveaux, Philippe; Léderlin, P.; Béné, Marie C.; Labouyrie, Eric

doi:10.1038/modpathol.3800156

Cited by 38 publications

(32 citation statements)

References 33 publications

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“…Thus, it is not apparent how improvements in CR rates with novel agents can therefore be considered 'cosmetic,' when they have led to significant prolongation in overall survival, as confirmed in multiple randomized trials. [3][4][5][6][7][8] Further, we do not agree that pursuing 'ever higher complete responses' by combining novel agents with conventional agents and/or transplant is unwarranted, especially as historical analyses of survival before and after the introduction of novel agents in clinical practice are showing a positive impact on patient survival, which is the first time in the last 20 years that such a change has been seen. 9,10 In the second part of the editorial, the commentary is much less clear.…”

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confidence: 99%

“…Intravascular B-cell infiltrates, constantly associated with Bcl-2 immunostaining as seen in some lymphomas, have been reported in PPBL patients. 7 Moreover, multiple Bcl-2/IgH gene rearrangements, mostly polyclonal, but possibly leading to oligoclonal expansion, were observed contributing to the emergence of non-Hodgkin's lymphoma. The genetic predisposition, 8 the persistent viral infection, the chromosomal instability 9 or genetic alterations of ataxia-telangiectasiamutated and Rad3-related gene leading to loss of cell differentiation and cell-cycle abnormalities 10 could explain the possibility of increase of the risk of cancer.…”

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confidence: 99%

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Long-term follow-up of 111 patients with persistent polyclonal B-cell lymphocytosis with binucleated lymphocytes

Cornet

Lesesve

Mossafa³

et al. 2008

Leukemia

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confidence: 99%

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confidence: 99%

Long-term follow-up of 111 patients with persistent polyclonal B-cell lymphocytosis with binucleated lymphocytes

Cornet

Lesesve

Mossafa³

et al. 2008

Leukemia

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“…Nevertheless, some features could suggest a link between PPBL and SMZL. Both entities share same histologic patterns: 1/expansion of the white pulp of the spleen, with an enlargement of the marginal zone area of the follicles, and an intrasinusoidal infiltration of the red pulp [7,8] and 2/ intrasinusoidal infiltration by polyclonal B-cells in bone marrow [7,9]. Phenotypical characterization by MFC is also similar between the two entities, with the expression of surface IgM, CD19, CD20 and CD79b, but lacking the expression of CD5, CD10, CD23, CD43 and CD103 (WHO classification, 2008).…”

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confidence: 99%

Occurrence of Non-Hodgkin Lymphoma after the Diagnosis of Persistent Polyclonal B-cell Lymphocytosis

Mear¹

2015

J Leuk

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on a routine blood count in 1988. A mild thrombopenia, constantly above 100×10 9 /L was iteratively reported on blood count since 1996, and binucleated lymphocytes were described on blood smears since 1997. The patient reported no clinical symptomatology. Clinical examination at diagnosis revealed a splenomegaly. There was no hepatomegaly or enlarged lymph nodes. On blood count, hemoglobin was 131 g/L, with 123×10 Though polyclonal, recurrent genetic abnormalities have been described in PPBL, supernumerary isochromosome 3q (+i(3)(q10)) being the most frequently described [3]. We report the cases of two patients with PPBL, where B-NHL occurred after PPBL diagnosis, splenic zone marginal lymphoma (SMZL) and diffuse large B-cell 41 lymphoma (DLBCL), leading us to raise the question of a relationshipbetween PPBL and B-42 NHL. Material and Methods Multiparameter flow cytometry (MFC)Lymphocytes were isolated from blood samples by gradient density. For splenic samples, cell suspension was obtained after mechanical dissociation of tissue. Lymphocytes were immunophenotyped by using 4-color direct immunofluorescence on a BD FACS CANTO II (Becton Dickinson, Franklin Lake, NJ, USA). PCR amplification, cloning, and sequencing analysisDNA was extracted from samples using routine procedures. PCR analysis of B-cell clonality was performed following the recommendations of BIOMED 2 protocols [4]. CytogeneticsConventional cytogenetics and interphase Fluorescence In Situ Hybridization (FISH) were performed on peripheral blood and on spleen lysates as described elsewhere [5]. First case: Occurrence of pulmonary DLBCL 13 years after PPBL diagnosisThe first patient is a 42-year-old man, who smoked 30 cigarettes each day. The lymphocytosis (8.5×10 9 /L) was fortuitously discovered AbstractPersistent polyclonal B cell lymphocytosis (PPBL) is a rare indolent condition characterized by a polyclonal expansion of B cells associated with binucleated lymphocytes observable on blood smears. Though polyclonal, recurrent genetic abnormalities have been described in PPBL, supernumerary isochromosome 3q (+i(3)(q10)) being the most frequently described. We report here two clinical observations showing the occurrence of NHL after the diagnosis of PPBL. These observations lead us to recommend a closer follow-up of PPBL patients and raise the question of a relationship between PPBL and NHL. Journal of LeukemiaJ o u r n a l of Le u k e m ia

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“…Bei der Mehrheit der Patienten finden sich polyklonale Rearrangements des IgH-Lokus mit dem BCL-2 Protoonkogen. Diese für das follikuläre Lymphom typische Translokation macht in der Differentialdiagnose die Abgrenzung zu einem leukämisch verlaufenden follikulären Lymphom notwendig [5]. Bei unserer Patientin konnten wir im peripheren Blut weder mittels FISH-Analyse noch mit PCR ein Rearrangement des IgH-Lokus nachweisen.…”

Section: äTiologie Und Pathogenese Der Ppblunclassified

Asymptomatische 32-jährige Raucherin mit persistierender Lymphozytose

et al. 2007

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A 32 year old female smoker (20 pack years) presented with an asymptomatic lymphocytosis of 13,000/nl and splenomegaly. The patient's blood smear showed an absolute lymphocytosis with 65% atypical lymphocytes. A total of 1% of the lymphocytes were bilobulated. Bone marrow histology and immunphenotyping of blood and bone marrow excluded leukemia and non-Hodgkin's lymphoma. IgH-CDR-3 PCR analysis revealed a polyclonal pattern. In summary, a persistent polyclonal B-cell-lymphocytosis (PPBL) was diagnosed. The exact etiology of PPBL is still unclear, however, it is associated with a polyclonal raise in the lymphocyte count of CD27+IgD+-memory-B-lymphocytes due to a defect in apoptosis signaling and leukocyte homing to secondary lymphoid tissues. An association with cigarette smoking is obvious since all patients are smokers. From all published cases, only two developed a malignancy with an uncertain association with PPBL. We have been monitoring our patient for 6.5 years without any evidence of the development of a lymphoma.

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Intravascular bone marrow accumulation in persistent polyclonal lymphocytosis: a misleading feature for B-cell neoplasm

Cited by 38 publications

References 33 publications

Long-term follow-up of 111 patients with persistent polyclonal B-cell lymphocytosis with binucleated lymphocytes

Long-term follow-up of 111 patients with persistent polyclonal B-cell lymphocytosis with binucleated lymphocytes

Occurrence of Non-Hodgkin Lymphoma after the Diagnosis of Persistent Polyclonal B-cell Lymphocytosis

Asymptomatische 32-jährige Raucherin mit persistierender Lymphozytose

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