Abstract
Monoclonal B-cell lymphocytosis (MBL) is a clonal B-cell disorder characterized by less than 5 × 109/L B lymphocytes in the peripheral blood, with a characteristic immuno-phenotype and no lymphadenopathy or organomegaly. The vast majority of MBL cases express the immuno phenotype of chronic lymphocytic leukemia (CLL; CLL-like MBL), although non-CLL MBL also exists. CLL-like MBL, which is the focus of this review, is divided into low-count MBL (median B-cell count: 0.001 × 109/L, typically identified in population-based screening studies using highly sensitive flow cytometry assays) and high-count MBL (clinical MBL, median B-cell count: 2.9 × 109/L, typically identified during the workup of low-level lymphocytosis). Low-count MBL has an exceedingly small risk of progression to CLL, and these patients do not require any specific follow-up. In contrast, patients with high-count MBL have a 1% to 2% per year risk of progression to CLL requiring therapy, as well as a higher risk of infectious complications and secondary malignancies. Although the overall survival of high-count MBL patients collectively is similar to the age- and sex-matched general population, 5-year survival for CD38+ high-count MBL is approximately 10% to 20% lower than the general population. This review summarizes key concepts in the classification, diagnosis, and biology of CLL-like MBL and addresses several important issues in clinical management.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 720-729 |
| Number of pages | 10 |
| Journal | Clinical Advances in Hematology and Oncology |
| Volume | 11 |
| Issue number | 11 |
| State | Published - 2013 |
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Keywords
- Chronic lymphocytic leukemia
- Classifcation
- Clinical management
- Diagnosis
- Monoclonal B-cell lymphocytosis
ASJC Scopus subject areas
- Oncology
- Hematology
- Medicine(all)
Cite this
Monoclonal B-cell lymphocytosis : Update on diagnosis, clinical outcome, and counseling. / Parikh, Sameer A; Kay, Neil Elliot; Shanafelt, Tait D.
In: Clinical Advances in Hematology and Oncology, Vol. 11, No. 11, 2013, p. 720-729.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Monoclonal B-cell lymphocytosis
T2 - Update on diagnosis, clinical outcome, and counseling
AU - Parikh, Sameer A
AU - Kay, Neil Elliot
AU - Shanafelt, Tait D.
PY - 2013
Y1 - 2013
N2 - Monoclonal B-cell lymphocytosis (MBL) is a clonal B-cell disorder characterized by less than 5 × 109/L B lymphocytes in the peripheral blood, with a characteristic immuno-phenotype and no lymphadenopathy or organomegaly. The vast majority of MBL cases express the immuno phenotype of chronic lymphocytic leukemia (CLL; CLL-like MBL), although non-CLL MBL also exists. CLL-like MBL, which is the focus of this review, is divided into low-count MBL (median B-cell count: 0.001 × 109/L, typically identified in population-based screening studies using highly sensitive flow cytometry assays) and high-count MBL (clinical MBL, median B-cell count: 2.9 × 109/L, typically identified during the workup of low-level lymphocytosis). Low-count MBL has an exceedingly small risk of progression to CLL, and these patients do not require any specific follow-up. In contrast, patients with high-count MBL have a 1% to 2% per year risk of progression to CLL requiring therapy, as well as a higher risk of infectious complications and secondary malignancies. Although the overall survival of high-count MBL patients collectively is similar to the age- and sex-matched general population, 5-year survival for CD38+ high-count MBL is approximately 10% to 20% lower than the general population. This review summarizes key concepts in the classification, diagnosis, and biology of CLL-like MBL and addresses several important issues in clinical management.
AB - Monoclonal B-cell lymphocytosis (MBL) is a clonal B-cell disorder characterized by less than 5 × 109/L B lymphocytes in the peripheral blood, with a characteristic immuno-phenotype and no lymphadenopathy or organomegaly. The vast majority of MBL cases express the immuno phenotype of chronic lymphocytic leukemia (CLL; CLL-like MBL), although non-CLL MBL also exists. CLL-like MBL, which is the focus of this review, is divided into low-count MBL (median B-cell count: 0.001 × 109/L, typically identified in population-based screening studies using highly sensitive flow cytometry assays) and high-count MBL (clinical MBL, median B-cell count: 2.9 × 109/L, typically identified during the workup of low-level lymphocytosis). Low-count MBL has an exceedingly small risk of progression to CLL, and these patients do not require any specific follow-up. In contrast, patients with high-count MBL have a 1% to 2% per year risk of progression to CLL requiring therapy, as well as a higher risk of infectious complications and secondary malignancies. Although the overall survival of high-count MBL patients collectively is similar to the age- and sex-matched general population, 5-year survival for CD38+ high-count MBL is approximately 10% to 20% lower than the general population. This review summarizes key concepts in the classification, diagnosis, and biology of CLL-like MBL and addresses several important issues in clinical management.
KW - Chronic lymphocytic leukemia
KW - Classifcation
KW - Clinical management
KW - Diagnosis
KW - Monoclonal B-cell lymphocytosis
UR - http://www.scopus.com/inward/record.url?scp=84889608334&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84889608334&partnerID=8YFLogxK
M3 - Article
C2 - 24896545
AN - SCOPUS:84889608334
VL - 11
SP - 720
EP - 729
JO - Clinical Advances in Hematology and Oncology
JF - Clinical Advances in Hematology and Oncology
SN - 1543-0790
IS - 11
ER -