Frequent clonal abnormalities of chromosome band 13q 14 in b‐cell chronic lymphocytic leukemia: Multiple clones, subclones, and nonclonal alterations in 82 midwestern patients

We performed cytogenetic analyses of peripheral blood lymphocytes from 82 Midwestern B‐cell chronic lymphocytic leukemia (B‐CLL) patients. The cells were cultured with mitogens for 3‐4 days. At least 15 metaphase cells were analyzed in 79 (96%) cases. Fifty (63%) of the 79 patients had clonal chromosomal alterations. Structural modifications of the long arm of chromosome 13 at or near band 13q14 were the most frequent abnormalities, identified in 23 (46%) of the patients with clonal abnormalities. In several patients, the abnormality involving band 13q14 was the sole chromosomal alteration. There was a high incidence of complex karyotypes. Nine patients had multiple subclones that appeared to result from clonal evolution; seven patients had cytogenetically unrelated clones; three patients had both subclones and cytogenetically unrelated clones. Nonclonal abnormalities were also prominent. Our study confirms the high incidence of clonal abnormalities involving chromosome arm 13q and documents the clustering of abnormalities at band 13q14 in B‐CLL. The evidence for clonal evolution and the presence of multiple unrelated clones in these patients suggest that B‐CLL may not be a karyotypically stable disease.