Monoclonal B-cell Lymphocytosis (MBL): Biology, Natural History and Clinical Management

Overview

Journal Leukemia

Specialties Hematology
Oncology

Date 2010 Jan 22

PMID 20090778

Citations 82

Authors

T D Shanafelt

P Ghia

M C Lanasa

O Landgren

A C Rawstron

Affiliations

Soon will be listed here.

Abstract

Chronic lymphocytic leukemia (CLL) and the other low-grade non-Hodgkin lymphomas are among the most common lymphoid malignancies. Recent studies suggest that more than 4% of the general population over age 40 harbor a population of clonal B cells with the phenotype of either CLL or another B-cell malignancy, a condition now designated monoclonal B-cell lymphocytosis (MBL). Although all cases of CLL appear to be preceded by MBL, the majority of individuals with MBL will not develop a hematologic malignancy. The biologic characteristics and clinical implications of MBL appear to differ based on whether it is identified during the diagnostic evaluation of lymphocytosis or incidentally discovered through screening of individuals with normal lymphocyte counts as part of research studies using highly sensitive detection methods. In this paper, we provide a state of the art review on the prevalence, nomenclature, biology, natural history and clinical management of MBL.

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References

Damle R, Wasil T, Fais F, Ghiotto F, Valetto A, Allen S . Ig V gene mutation status and CD38 expression as novel prognostic indicators in chronic lymphocytic leukemia. Blood. 1999; 94(6):1840-7. View

Ghia P, Prato G, Scielzo C, Stella S, Geuna M, Guida G . Monoclonal CD5+ and CD5- B-lymphocyte expansions are frequent in the peripheral blood of the elderly. Blood. 2003; 103(6):2337-42. DOI: 10.1182/blood-2003-09-3277. View

Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun M . Cancer statistics, 2009. CA Cancer J Clin. 2009; 59(4):225-49. DOI: 10.3322/caac.20006. View

Mulligan C, Thomas M, Mulligan S . Monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia. N Engl J Med. 2008; 359(19):2065-6. DOI: 10.1056/NEJMc086211. View

Emanuel E, Wendler D, Grady C . What makes clinical research ethical?. JAMA. 2000; 283(20):2701-11. DOI: 10.1001/jama.283.20.2701. View

Rawstron A, Bennett F, Hillmen P . The biological and clinical relationship between CD5+23+ monoclonal B-cell lymphocytosis and chronic lymphocytic leukaemia. Br J Haematol. 2007; 139(5):724-9. DOI: 10.1111/j.1365-2141.2007.06863.x. View

Goldin L, Pfeiffer R, Li X, Hemminki K . Familial risk of lymphoproliferative tumors in families of patients with chronic lymphocytic leukemia: results from the Swedish Family-Cancer Database. Blood. 2004; 104(6):1850-4. DOI: 10.1182/blood-2004-01-0341. View

Matos D, Ismael S, Scrideli C, de Oliveira F, Rego E, Falcao R . Monoclonal B-cell lymphocytosis in first-degree relatives of patients with sporadic (non-familial) chronic lymphocytic leukaemia. Br J Haematol. 2009; 147(3):339-46. DOI: 10.1111/j.1365-2141.2009.07861.x. View

Rawstron A, Yuille M, Fuller J, Cullen M, Kennedy B, Richards S . Inherited predisposition to CLL is detectable as subclinical monoclonal B-lymphocyte expansion. Blood. 2002; 100(7):2289-90. DOI: 10.1182/blood-2002-03-0892. View

10.

Shim Y, Vogt R, Middleton D, Abbasi F, Slade B, Lee K . Prevalence and natural history of monoclonal and polyclonal B-cell lymphocytosis in a residential adult population. Cytometry B Clin Cytom. 2007; 72(5):344-53. DOI: 10.1002/cyto.b.20174. View

11.

Shanafelt T, Bowen D, Venkat C, Slager S, Zent C, Kay N . The physician-patient relationship and quality of life: lessons from chronic lymphocytic leukemia. Leuk Res. 2008; 33(2):263-70. PMC: 2643424. DOI: 10.1016/j.leukres.2008.06.019. View

12.

Shanafelt T, Kay N, Rabe K, Call T, Zent C, Maddocks K . Brief report: natural history of individuals with clinically recognized monoclonal B-cell lymphocytosis compared with patients with Rai 0 chronic lymphocytic leukemia. J Clin Oncol. 2009; 27(24):3959-63. PMC: 2734397. DOI: 10.1200/JCO.2008.21.2704. View

13.

Rachel J, Zucker M, Fox C, Plapp F, Menitove J, Abbasi F . Monoclonal B-cell lymphocytosis in blood donors. Br J Haematol. 2007; 139(5):832-6. DOI: 10.1111/j.1365-2141.2007.06870.x. View

14.

Rawstron A, Kennedy B, Evans P, Davies F, Richards S, Haynes A . Quantitation of minimal disease levels in chronic lymphocytic leukemia using a sensitive flow cytometric assay improves the prediction of outcome and can be used to optimize therapy. Blood. 2001; 98(1):29-35. DOI: 10.1182/blood.v98.1.29. View

15.

Sorror M, Storer B, Sandmaier B, Maris M, Shizuru J, Maziarz R . Five-year follow-up of patients with advanced chronic lymphocytic leukemia treated with allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning. J Clin Oncol. 2008; 26(30):4912-20. PMC: 2652085. DOI: 10.1200/JCO.2007.15.4757. View

16.

Hoffbrand A, Hamblin T . Is "leukemia" an appropriate label for all patients who meet the diagnostic criteria of chronic lymphocytic leukemia?. Leuk Res. 2006; 31(3):273-5. DOI: 10.1016/j.leukres.2006.07.006. View

17.

Murray F, Darzentas N, Hadzidimitriou A, Tobin G, Boudjogra M, Scielzo C . Stereotyped patterns of somatic hypermutation in subsets of patients with chronic lymphocytic leukemia: implications for the role of antigen selection in leukemogenesis. Blood. 2007; 111(3):1524-33. DOI: 10.1182/blood-2007-07-099564. View

18.

Einstein A, Henzlova M, Rajagopalan S . Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007; 298(3):317-23. DOI: 10.1001/jama.298.3.317. View

19.

Lanasa M, Allgood S, Volkheimer A, Gockerman J, Whitesides J, Goodman B . Single-cell analysis reveals oligoclonality among 'low-count' monoclonal B-cell lymphocytosis. Leukemia. 2009; 24(1):133-40. PMC: 2806490. DOI: 10.1038/leu.2009.192. View

20.

Shanafelt T, Bowen D, Venkat C, Slager S, Zent C, Kay N . Quality of life in chronic lymphocytic leukemia: an international survey of 1482 patients. Br J Haematol. 2007; 139(2):255-64. DOI: 10.1111/j.1365-2141.2007.06791.x. View