MBL or CLL: Which classification best categorizes the clinical course of patients with an absolute lymphocyte count ≥ 5 × 109 L-1 but a B-cell lymphocyte count < 5 × 109 L-1?

Tait D. Shanafelt; Neil E. Kay; Tim G. Call; Clive S. Zent; Diane F. Jelinek; Betsy LaPlant; William G. Morice; Curtis A. Hanson

doi:10.1016/j.leukres.2007.11.030

MBL or CLL: Which classification best categorizes the clinical course of patients with an absolute lymphocyte count ≥ 5 × 10⁹ L^-1 but a B-cell lymphocyte count < 5 × 10⁹ L^-1?

Tait D. Shanafelt, Neil E. Kay, Tim G. Call, Clive S. Zent, Diane F. Jelinek, Betsy LaPlant, William G. Morice, Curtis A. Hanson

Research output: Contribution to journal › Article › peer-review

41 Scopus citations

Abstract

To eliminate overlap with monoclonal B-cell lymphocytosis (MBL), some have proposed basing the diagnosis of chronic lymphocytic leukemia (CLL) on B lymphocyte count rather than absolute lymphocyte count (ALC). Such criteria should be based, in part, on patient outcomes. We evaluated the clinical implications of the proposed re-classification in 112 consecutive, newly diagnosed, Rai stage 0 patients. The new criteria would have changed the diagnosis from CLL to MBL in 47/112 (42%) patients. There was no difference in time to treatment (TTT) between those classified as MBL and CLL under the new criteria. In contrast, CD38 predicted TTT (p = 0.02) regardless of the proposed new classification. Molecular characteristics of the leukemic clone are a better predictor of progression than an arbitrary ALC or B lymphocyte count threshold.

Original language	English (US)
Pages (from-to)	1458-1461
Number of pages	4
Journal	Leukemia Research
Volume	32
Issue number	9
DOIs	https://doi.org/10.1016/j.leukres.2007.11.030
State	Published - Sep 2008

Keywords

Chronic lymphocytic leukemia
Diangosis
Monoclonal B-cell lymphocytosis
Prognosis

ASJC Scopus subject areas

Hematology
Oncology
Cancer Research

Access to Document

10.1016/j.leukres.2007.11.030

Cite this

Shanafelt, T. D., Kay, N. E., Call, T. G., Zent, C. S., Jelinek, D. F., LaPlant, B., Morice, W. G., & Hanson, C. A. (2008). MBL or CLL: Which classification best categorizes the clinical course of patients with an absolute lymphocyte count ≥ 5 × 10⁹ L^-1 but a B-cell lymphocyte count < 5 × 10⁹ L^-1? Leukemia Research, 32(9), 1458-1461. https://doi.org/10.1016/j.leukres.2007.11.030

Shanafelt, TD, Kay, NE, Call, TG, Zent, CS, Jelinek, DF, LaPlant, B, Morice, WG & Hanson, CA 2008, 'MBL or CLL: Which classification best categorizes the clinical course of patients with an absolute lymphocyte count ≥ 5 × 10⁹ L^-1 but a B-cell lymphocyte count < 5 × 10⁹ L^-1?', Leukemia Research, vol. 32, no. 9, pp. 1458-1461. https://doi.org/10.1016/j.leukres.2007.11.030

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title = "MBL or CLL: Which classification best categorizes the clinical course of patients with an absolute lymphocyte count ≥ 5 × 109 L-1 but a B-cell lymphocyte count < 5 × 109 L-1?",

abstract = "To eliminate overlap with monoclonal B-cell lymphocytosis (MBL), some have proposed basing the diagnosis of chronic lymphocytic leukemia (CLL) on B lymphocyte count rather than absolute lymphocyte count (ALC). Such criteria should be based, in part, on patient outcomes. We evaluated the clinical implications of the proposed re-classification in 112 consecutive, newly diagnosed, Rai stage 0 patients. The new criteria would have changed the diagnosis from CLL to MBL in 47/112 (42%) patients. There was no difference in time to treatment (TTT) between those classified as MBL and CLL under the new criteria. In contrast, CD38 predicted TTT (p = 0.02) regardless of the proposed new classification. Molecular characteristics of the leukemic clone are a better predictor of progression than an arbitrary ALC or B lymphocyte count threshold.",

keywords = "Chronic lymphocytic leukemia, Diangosis, Monoclonal B-cell lymphocytosis, Prognosis",

author = "Shanafelt, {Tait D.} and Kay, {Neil E.} and Call, {Tim G.} and Zent, {Clive S.} and Jelinek, {Diane F.} and Betsy LaPlant and Morice, {William G.} and Hanson, {Curtis A.}",

note = "Funding Information: Support through grants from the National Cancer Institute (NCI CA 113408) gratefully acknowledged.",

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AU - Zent, Clive S.

AU - Jelinek, Diane F.

AU - LaPlant, Betsy

AU - Morice, William G.

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