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 Elliot Kay, Tim G. Call, Clive S. Zent, Diane F Jelinek, Betsy LaPlant, William G. Morice, Curtis A. Hanson

Research output: Contribution to journalArticle

38 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 languageEnglish (US)
Pages (from-to)1458-1461
Number of pages4
JournalLeukemia Research
Volume32
Issue number9
DOIs
StatePublished - Sep 2008

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Keywords

  • Chronic lymphocytic leukemia
  • Diangosis
  • Monoclonal B-cell lymphocytosis
  • Prognosis

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

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