CD5-positive chronic B-cell lymphoproliferative disorders: diagnosis and prognosis of a heterogeneous disease entity

Roxana S Dronca, Dragan Jevremovic, Curtis A. Hanson, Kari G. Rabe, Tait D. Shanafelt, William G. Morice, Timothy G. Call, Neil Elliot Kay, C. Scott Collins, Susan M. Schwager, Susan L Slager, Clive S. Zent

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: The pathology and clinical course of patients with CD5+ chronic B-cell lymphoproliferative disorders, excluding those that present with typical chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) or mantle cell lymphoma, (i.e. CD5+B-CLPD) are poorly defined. Methods: We studied patients with CD5+B-CLPD to (1) more completely define the clinical features and pathology of CD5+B-CLPD, (2) compare these features to patients presenting with typical CLL, and (3) test the hypothesis that a subset of patients with CD5+B-CLPD could have a unique B-cell malignancy. Results: We identified 229 patients with CD5+B-CLPD. A definitive pathological diagnosis was made in all 61 (27%) CD5+B-CLPD patients with nonbone marrow (BM) biopsy specimens considered adequate for a comprehensive pathological examination. The most common diagnosis among these 61 patients was CLL (44%) followed by the leukemic phase of marginal zone lymphoma (34%), lymphoplasmacytic lymphoma (11%), diffuse large B cell lymphoma (8%), and high-grade B cell lymphoma not otherwise specified (2%). In contrast, among 168 patients without a non-BM tissue biopsy specimen, a specific diagnosis could be made on review of all available data in only 24 (14%) with 144 (86%) remaining "unclassified." Conclusions: In patients with CD5+B-CLPD, a definitive diagnosis can be made on an adequate non-BM tissue biopsy suggesting that this entity does not include a novel disease. We recommend that all patients with CD5+B-CLPD should have a non-BM tissue biopsy to make a definitive diagnosis prior to initiation of treatment.

Original languageEnglish (US)
JournalCytometry Part B - Clinical Cytometry
Volume78
Issue numberSUPPL. 1
DOIs
StatePublished - 2010

Fingerprint

Lymphoproliferative Disorders
B-Lymphocytes
Biopsy
Clinical Pathology
B-Cell Lymphoma
B-Cell Chronic Lymphocytic Leukemia
Mantle-Cell Lymphoma
Lymphoma, Large B-Cell, Diffuse
Non-Hodgkin's Lymphoma
Lymphoma
Bone Marrow

Keywords

  • B cell
  • CD5
  • Chronic lymphoproliferative disorders
  • CLL
  • Lymphoma
  • SLL

ASJC Scopus subject areas

  • Cell Biology
  • Histology
  • Pathology and Forensic Medicine

Cite this

CD5-positive chronic B-cell lymphoproliferative disorders : diagnosis and prognosis of a heterogeneous disease entity. / Dronca, Roxana S; Jevremovic, Dragan; Hanson, Curtis A.; Rabe, Kari G.; Shanafelt, Tait D.; Morice, William G.; Call, Timothy G.; Kay, Neil Elliot; Collins, C. Scott; Schwager, Susan M.; Slager, Susan L; Zent, Clive S.

In: Cytometry Part B - Clinical Cytometry, Vol. 78, No. SUPPL. 1, 2010.

Research output: Contribution to journalArticle

Dronca, Roxana S ; Jevremovic, Dragan ; Hanson, Curtis A. ; Rabe, Kari G. ; Shanafelt, Tait D. ; Morice, William G. ; Call, Timothy G. ; Kay, Neil Elliot ; Collins, C. Scott ; Schwager, Susan M. ; Slager, Susan L ; Zent, Clive S. / CD5-positive chronic B-cell lymphoproliferative disorders : diagnosis and prognosis of a heterogeneous disease entity. In: Cytometry Part B - Clinical Cytometry. 2010 ; Vol. 78, No. SUPPL. 1.
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abstract = "Background: The pathology and clinical course of patients with CD5+ chronic B-cell lymphoproliferative disorders, excluding those that present with typical chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) or mantle cell lymphoma, (i.e. CD5+B-CLPD) are poorly defined. Methods: We studied patients with CD5+B-CLPD to (1) more completely define the clinical features and pathology of CD5+B-CLPD, (2) compare these features to patients presenting with typical CLL, and (3) test the hypothesis that a subset of patients with CD5+B-CLPD could have a unique B-cell malignancy. Results: We identified 229 patients with CD5+B-CLPD. A definitive pathological diagnosis was made in all 61 (27{\%}) CD5+B-CLPD patients with nonbone marrow (BM) biopsy specimens considered adequate for a comprehensive pathological examination. The most common diagnosis among these 61 patients was CLL (44{\%}) followed by the leukemic phase of marginal zone lymphoma (34{\%}), lymphoplasmacytic lymphoma (11{\%}), diffuse large B cell lymphoma (8{\%}), and high-grade B cell lymphoma not otherwise specified (2{\%}). In contrast, among 168 patients without a non-BM tissue biopsy specimen, a specific diagnosis could be made on review of all available data in only 24 (14{\%}) with 144 (86{\%}) remaining {"}unclassified.{"} Conclusions: In patients with CD5+B-CLPD, a definitive diagnosis can be made on an adequate non-BM tissue biopsy suggesting that this entity does not include a novel disease. We recommend that all patients with CD5+B-CLPD should have a non-BM tissue biopsy to make a definitive diagnosis prior to initiation of treatment.",
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T1 - CD5-positive chronic B-cell lymphoproliferative disorders

T2 - diagnosis and prognosis of a heterogeneous disease entity

AU - Dronca, Roxana S

AU - Jevremovic, Dragan

AU - Hanson, Curtis A.

AU - Rabe, Kari G.

AU - Shanafelt, Tait D.

AU - Morice, William G.

AU - Call, Timothy G.

AU - Kay, Neil Elliot

AU - Collins, C. Scott

AU - Schwager, Susan M.

AU - Slager, Susan L

AU - Zent, Clive S.

PY - 2010

Y1 - 2010

N2 - Background: The pathology and clinical course of patients with CD5+ chronic B-cell lymphoproliferative disorders, excluding those that present with typical chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) or mantle cell lymphoma, (i.e. CD5+B-CLPD) are poorly defined. Methods: We studied patients with CD5+B-CLPD to (1) more completely define the clinical features and pathology of CD5+B-CLPD, (2) compare these features to patients presenting with typical CLL, and (3) test the hypothesis that a subset of patients with CD5+B-CLPD could have a unique B-cell malignancy. Results: We identified 229 patients with CD5+B-CLPD. A definitive pathological diagnosis was made in all 61 (27%) CD5+B-CLPD patients with nonbone marrow (BM) biopsy specimens considered adequate for a comprehensive pathological examination. The most common diagnosis among these 61 patients was CLL (44%) followed by the leukemic phase of marginal zone lymphoma (34%), lymphoplasmacytic lymphoma (11%), diffuse large B cell lymphoma (8%), and high-grade B cell lymphoma not otherwise specified (2%). In contrast, among 168 patients without a non-BM tissue biopsy specimen, a specific diagnosis could be made on review of all available data in only 24 (14%) with 144 (86%) remaining "unclassified." Conclusions: In patients with CD5+B-CLPD, a definitive diagnosis can be made on an adequate non-BM tissue biopsy suggesting that this entity does not include a novel disease. We recommend that all patients with CD5+B-CLPD should have a non-BM tissue biopsy to make a definitive diagnosis prior to initiation of treatment.

AB - Background: The pathology and clinical course of patients with CD5+ chronic B-cell lymphoproliferative disorders, excluding those that present with typical chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) or mantle cell lymphoma, (i.e. CD5+B-CLPD) are poorly defined. Methods: We studied patients with CD5+B-CLPD to (1) more completely define the clinical features and pathology of CD5+B-CLPD, (2) compare these features to patients presenting with typical CLL, and (3) test the hypothesis that a subset of patients with CD5+B-CLPD could have a unique B-cell malignancy. Results: We identified 229 patients with CD5+B-CLPD. A definitive pathological diagnosis was made in all 61 (27%) CD5+B-CLPD patients with nonbone marrow (BM) biopsy specimens considered adequate for a comprehensive pathological examination. The most common diagnosis among these 61 patients was CLL (44%) followed by the leukemic phase of marginal zone lymphoma (34%), lymphoplasmacytic lymphoma (11%), diffuse large B cell lymphoma (8%), and high-grade B cell lymphoma not otherwise specified (2%). In contrast, among 168 patients without a non-BM tissue biopsy specimen, a specific diagnosis could be made on review of all available data in only 24 (14%) with 144 (86%) remaining "unclassified." Conclusions: In patients with CD5+B-CLPD, a definitive diagnosis can be made on an adequate non-BM tissue biopsy suggesting that this entity does not include a novel disease. We recommend that all patients with CD5+B-CLPD should have a non-BM tissue biopsy to make a definitive diagnosis prior to initiation of treatment.

KW - B cell

KW - CD5

KW - Chronic lymphoproliferative disorders

KW - CLL

KW - Lymphoma

KW - SLL

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