SEARCH:   Advanced

Blood, 2 July 2009, Vol. 114, No. 1, pp. 26-32. Prepublished online as a Blood First Edition Paper on November 24, 2008; DOI 10.1182/blood-2008-09-176933. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-09-176933v1 114/1/26    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Google Scholar Articles by Dagklis, A. Articles by Ghia, P. PubMed PubMed Citation Articles by Dagklis, A. Articles by Ghia, P. Related Collections Free Research Articles Lymphoid Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS The immunoglobulin gene repertoire of low-count chronic lymphocytic leukemia (CLL)–like monoclonal B lymphocytosis is different from CLL: diagnostic implications for clinical monitoring Antonis Dagklis1,*, Claudia Fazi1,*, Cinzia Sala1, Valeria Cantarelli1, Cristina Scielzo1, Roberto Massacane2, Daniela Toniolo1, Federico Caligaris-Cappio1, Kostas Stamatopoulos3, and Paolo Ghia1 1 Laboratory and Unit of Lymphoid Malignancies, Department of Oncology, Università Vita-Salute San Raffaele e Istituto Scientifico San Raffaele, Milano, Italy; 2 Laboratorio Analisi ASL 22 - PO, Novi Ligure, Italy; and 3 Hematology Department and HCT Unit, G Papanicolaou Hospital, Thessaloniki, Greece In the revised National Cancer Institute Working Group (NCI-WG)/International Workshop on Chronic Lymphocytic Leukemia (IWCLL) guidelines for CLL, CLL-like monoclonal B lymphocytosis (MBL) is defined as the presence of less than 5 x 109/L B lymphocytes in the peripheral blood. However, the concentration of MBL in the blood is extremely variable. MBL in subjects with lymphocytosis require treatment at a rate of 1.1% per year and present immunoglobulin (IG) gene features and similar to good prognosis CLL. Little is known about low-count MBL cases, accidentally found in the general population. We analyzed IGHV-D-J rearrangements in 51 CLL-like MBL cases from healthy individuals, characterized by few clonal B cells. Seventy percent of the IGHV genes were mutated. The most frequent IGHV gene was IGHV4-59/61, rarely used in CLL, whereas the IGHV1–69 gene was lacking and the IGHV4-34 gene was infrequent. Only 2 of 51 (3.9%) MBL cases expressed a CLL-specific stereotyped HCDR3. Therefore, the IG gene repertoire in low-count MBL differs from both mutated and unmutated CLL, suggesting that the detection of MBL in an otherwise healthy subject is not always equivalent to a preleukemic state. Detailed IG analysis of individual MBL may help to identify cases that necessitate continuous clinical monitoring to anticipate disease progression. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: W. G. Nieto, J. Almeida, A. Romero, C. Teodosio, A. Lopez, A. F. Henriques, M. L. Sanchez, M. Jara-Acevedo, A. Rasillo, M. Gonzalez, et al. Increased frequency (12%) of circulating chronic lymphocytic leukemia-like B-cell clones in healthy subjects using a highly sensitive multicolor flow cytometry approach Blood, July 2, 2009; 114(1): 33 - 37. [Abstract] [Full Text] [PDF] C. S. Mulligan, M. E. Thomas, and S. P. Mulligan Lymphocytes, B lymphocytes, and clonal CLL cells: observations on the impact of the new diagnostic criteria in the 2008 Guidelines for Chronic Lymphocytic Leukemia (CLL) Blood, June 18, 2009; 113(25): 6496 - 6497. [Full Text] [PDF]

	Copyright © 2009 by American Society of Hematology         Online ISSN: 1528-0020