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Prepublished online as a Blood First Edition Paper on June 14, 2002; DOI 10.1182/blood-2002-03-0892.

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Submitted April 2, 2002
Accepted May 2, 2002

Inherited predisposition to CLL is detectable as sub-clinical monoclonal B-lymphocyte expansion

Andy C Rawstron, Martin R Yuille, Julie Fuller, Matthew Cullen, Ben Kennedy, Stephen J Richards, Andrew S Jack, Estella Matutes, Daniel Catovsky, Peter Hillmen, and Richard S Houlston*

Academic Unit of Haematology and Oncology, University of Leeds, Leeds, West Yorkshire, United Kingdom
Academic Department of Haematology and Cytogenetics, Institute of Cancer Research, Sutton, Surrey, United Kingdom
Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, United Kingdom

* Corresponding author; email: r.houlston{at}icr.ac.uk.

Monoclonal CLL-phenotype cells are detectable in 3.5% of otherwise normal individuals using flow cytometric analysis of CD5/CD20/CD79b expression on CD19-gated B-cells. To determine whether detection of such CLL-phenotype cells is indicative of an inherited predisposition, we examined 59 healthy first-degree relatives of patients from 21 CLL families. CLL-phenotype cells were detected in 8/59 relatives (13.5%), representing a highly significant increase in risk (p=0.00002). CLL-phenotype cell levels were stable with time, and had the characteristics of indolent CLL. Both indolent and aggressive clinical forms were found in family members, suggesting that initiation and proliferation involves distinct factors. The detection of CLL-phenotype cells provides a surrogate marker of carrier status, potentially facilitating gene identification through mapping in families and direct analysis of isolated CLL-phenotype cells.


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