Brief report: Natural history of individuals with clinically recognized monoclonal B-cell lymphocytosis compared with patients with Rai 0 chronic lymphocytic leukemia

Tait D. Shanafelt, Neil Elliot Kay, Kari G. Rabe, Timothy G. Call, Clive S. Zent, Kami Maddocks, Greg Jenkins, Diane F Jelinek, William G. Morice, Justin Boysen, Susan Schwager, Deborah Bowen, Susan L Slager, Curtis A. Hanson

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Abstract

Purpose: The diagnosis of monoclonal B-cell lymphocytosis (MBL) is used to characterize patients with a circulating population of clonal B cells, a total B-cell count of less than 5 X 109/L, and no other features of a B-cell lymphoproliferative disorder including lymphadenopathy/organomegaly. The natural history of clinically identified MBL is unclear. The goal of this study was to explore the outcome of patients with MBL relative to that of individuals with Rai stage 0 chronic lymphocytic leukemia (CLL). Patients and Methods: We used hematopathology records to identify a cohort of 631 patients with newly diagnosed MBL or Rai stage 0 CLL. Within this cohort, 302 patients had MBL (B-cell counts of 0.02 to 4.99 X 109/L); 94 patients had Rai stage 0 CLL with an absolute lymphocyte count (ALC) ≤ 10 X 109/L; and 219 patients had Rai stage 0 CLL with an ALC more than 10 X 109/L. Data on clinical outcome were abstracted from medical records. Results: The percentage of MBL patients free of treatment at 1, 2, and 5 years was 99%, 98%, and 93%, respectively. B-cell count as a continuous variable (hazard ratio [HR] X 2.9, P = .04) and CD38 status (HR = 10.8, P = .006) predicted time to treatment (TTT) among MBL patients. The likelihood of treatment for MBL patients was lower (HR = 0.32, P = .04) than that of both Rai stage 0 CLL patients with an ALC less than 10 X 109/L (n = 94) and Rai stage 0 CLL patients with an ALC more than 10 X 109/L (n = 219; P = .0003). Conclusion: Individuals with MBL identified in clinical practice have a low risk for progression at 5 years. Because B-cell count seems to relate to TTT as a continuous variable, additional studies are needed to determine what B-cell count should be used to distinguish between MBL and CLL.

Original languageEnglish (US)
Pages (from-to)3959-3963
Number of pages5
JournalJournal of Clinical Oncology
Volume27
Issue number24
DOIs
StatePublished - Aug 20 2009

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Lymphocytosis
B-Cell Chronic Lymphocytic Leukemia
Natural History
B-Lymphocytes
Lymphocyte Count
Cell Count
Lymphoproliferative Disorders
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

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Brief report : Natural history of individuals with clinically recognized monoclonal B-cell lymphocytosis compared with patients with Rai 0 chronic lymphocytic leukemia. / Shanafelt, Tait D.; Kay, Neil Elliot; Rabe, Kari G.; Call, Timothy G.; Zent, Clive S.; Maddocks, Kami; Jenkins, Greg; Jelinek, Diane F; Morice, William G.; Boysen, Justin; Schwager, Susan; Bowen, Deborah; Slager, Susan L; Hanson, Curtis A.

In: Journal of Clinical Oncology, Vol. 27, No. 24, 20.08.2009, p. 3959-3963.

Research output: Contribution to journalArticle

Shanafelt, Tait D. ; Kay, Neil Elliot ; Rabe, Kari G. ; Call, Timothy G. ; Zent, Clive S. ; Maddocks, Kami ; Jenkins, Greg ; Jelinek, Diane F ; Morice, William G. ; Boysen, Justin ; Schwager, Susan ; Bowen, Deborah ; Slager, Susan L ; Hanson, Curtis A. / Brief report : Natural history of individuals with clinically recognized monoclonal B-cell lymphocytosis compared with patients with Rai 0 chronic lymphocytic leukemia. In: Journal of Clinical Oncology. 2009 ; Vol. 27, No. 24. pp. 3959-3963.
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abstract = "Purpose: The diagnosis of monoclonal B-cell lymphocytosis (MBL) is used to characterize patients with a circulating population of clonal B cells, a total B-cell count of less than 5 X 109/L, and no other features of a B-cell lymphoproliferative disorder including lymphadenopathy/organomegaly. The natural history of clinically identified MBL is unclear. The goal of this study was to explore the outcome of patients with MBL relative to that of individuals with Rai stage 0 chronic lymphocytic leukemia (CLL). Patients and Methods: We used hematopathology records to identify a cohort of 631 patients with newly diagnosed MBL or Rai stage 0 CLL. Within this cohort, 302 patients had MBL (B-cell counts of 0.02 to 4.99 X 109/L); 94 patients had Rai stage 0 CLL with an absolute lymphocyte count (ALC) ≤ 10 X 109/L; and 219 patients had Rai stage 0 CLL with an ALC more than 10 X 109/L. Data on clinical outcome were abstracted from medical records. Results: The percentage of MBL patients free of treatment at 1, 2, and 5 years was 99{\%}, 98{\%}, and 93{\%}, respectively. B-cell count as a continuous variable (hazard ratio [HR] X 2.9, P = .04) and CD38 status (HR = 10.8, P = .006) predicted time to treatment (TTT) among MBL patients. The likelihood of treatment for MBL patients was lower (HR = 0.32, P = .04) than that of both Rai stage 0 CLL patients with an ALC less than 10 X 109/L (n = 94) and Rai stage 0 CLL patients with an ALC more than 10 X 109/L (n = 219; P = .0003). Conclusion: Individuals with MBL identified in clinical practice have a low risk for progression at 5 years. Because B-cell count seems to relate to TTT as a continuous variable, additional studies are needed to determine what B-cell count should be used to distinguish between MBL and CLL.",
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T2 - Natural history of individuals with clinically recognized monoclonal B-cell lymphocytosis compared with patients with Rai 0 chronic lymphocytic leukemia

AU - Shanafelt, Tait D.

AU - Kay, Neil Elliot

AU - Rabe, Kari G.

AU - Call, Timothy G.

AU - Zent, Clive S.

AU - Maddocks, Kami

AU - Jenkins, Greg

AU - Jelinek, Diane F

AU - Morice, William G.

AU - Boysen, Justin

AU - Schwager, Susan

AU - Bowen, Deborah

AU - Slager, Susan L

AU - Hanson, Curtis A.

PY - 2009/8/20

Y1 - 2009/8/20

N2 - Purpose: The diagnosis of monoclonal B-cell lymphocytosis (MBL) is used to characterize patients with a circulating population of clonal B cells, a total B-cell count of less than 5 X 109/L, and no other features of a B-cell lymphoproliferative disorder including lymphadenopathy/organomegaly. The natural history of clinically identified MBL is unclear. The goal of this study was to explore the outcome of patients with MBL relative to that of individuals with Rai stage 0 chronic lymphocytic leukemia (CLL). Patients and Methods: We used hematopathology records to identify a cohort of 631 patients with newly diagnosed MBL or Rai stage 0 CLL. Within this cohort, 302 patients had MBL (B-cell counts of 0.02 to 4.99 X 109/L); 94 patients had Rai stage 0 CLL with an absolute lymphocyte count (ALC) ≤ 10 X 109/L; and 219 patients had Rai stage 0 CLL with an ALC more than 10 X 109/L. Data on clinical outcome were abstracted from medical records. Results: The percentage of MBL patients free of treatment at 1, 2, and 5 years was 99%, 98%, and 93%, respectively. B-cell count as a continuous variable (hazard ratio [HR] X 2.9, P = .04) and CD38 status (HR = 10.8, P = .006) predicted time to treatment (TTT) among MBL patients. The likelihood of treatment for MBL patients was lower (HR = 0.32, P = .04) than that of both Rai stage 0 CLL patients with an ALC less than 10 X 109/L (n = 94) and Rai stage 0 CLL patients with an ALC more than 10 X 109/L (n = 219; P = .0003). Conclusion: Individuals with MBL identified in clinical practice have a low risk for progression at 5 years. Because B-cell count seems to relate to TTT as a continuous variable, additional studies are needed to determine what B-cell count should be used to distinguish between MBL and CLL.

AB - Purpose: The diagnosis of monoclonal B-cell lymphocytosis (MBL) is used to characterize patients with a circulating population of clonal B cells, a total B-cell count of less than 5 X 109/L, and no other features of a B-cell lymphoproliferative disorder including lymphadenopathy/organomegaly. The natural history of clinically identified MBL is unclear. The goal of this study was to explore the outcome of patients with MBL relative to that of individuals with Rai stage 0 chronic lymphocytic leukemia (CLL). Patients and Methods: We used hematopathology records to identify a cohort of 631 patients with newly diagnosed MBL or Rai stage 0 CLL. Within this cohort, 302 patients had MBL (B-cell counts of 0.02 to 4.99 X 109/L); 94 patients had Rai stage 0 CLL with an absolute lymphocyte count (ALC) ≤ 10 X 109/L; and 219 patients had Rai stage 0 CLL with an ALC more than 10 X 109/L. Data on clinical outcome were abstracted from medical records. Results: The percentage of MBL patients free of treatment at 1, 2, and 5 years was 99%, 98%, and 93%, respectively. B-cell count as a continuous variable (hazard ratio [HR] X 2.9, P = .04) and CD38 status (HR = 10.8, P = .006) predicted time to treatment (TTT) among MBL patients. The likelihood of treatment for MBL patients was lower (HR = 0.32, P = .04) than that of both Rai stage 0 CLL patients with an ALC less than 10 X 109/L (n = 94) and Rai stage 0 CLL patients with an ALC more than 10 X 109/L (n = 219; P = .0003). Conclusion: Individuals with MBL identified in clinical practice have a low risk for progression at 5 years. Because B-cell count seems to relate to TTT as a continuous variable, additional studies are needed to determine what B-cell count should be used to distinguish between MBL and CLL.

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