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Blood, 15 June 2008, Vol. 111, No. 12, pp. 5691-5693.
Prepublished online as a Blood First Edition Paper on April 18, 2008; DOI 10.1182/blood-2008-03-142349.


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Submitted March 11, 2008
Accepted March 21, 2008

Insight into the pathogenesis of chronic lymphocytic leukemia (CLL) through analysis of IgVH gene usage and mutation status in familial CLL

Dalemari Crowther, Ruth Wild, Gabrielle Sellick, Martin J. S. Dyer, Francesca R Mauro, Robert J.G Cuthbert, Viggo Jonsson, Estella Matutes, Claire Dearden, James Wiley, Stephen Fuller, Daniel Catovsky, and Richard S Houlston*

Section of Cancer Genetics, Institute of Cancer Research, Sutton, United Kingdom
MRC toxicology Unit, Leicester University, Leicester, United Kingdom
Division of Hematology, Dipartmento di Biotechnologie Cellulari ed Ematologia, University "La Sapienza", Rome, Italy
Department of Haematology, Belfast City Hospital, Belfast, United Kingdom
Department of Haematology, Aker University Hospital, University of Oslo, Oslo
Royal Marsden Hospital, Sutton, United Kingdom
Department of Medicine, Sydney University, Nepean Hospital, Penrith, Australia
Section of Haemato-Oncology, Institute of Cancer Research, Sutton, United Kingdom
Section of Cancer Genetics, Insitute of Cancer Research, Sutton, United Kingdom

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

To address the proposition that familial B-cell chronic lymphocytic leukemia (CLL) may exhibit a more restricted phenotype than sporadic CLL with respect to immunoglobulin gene usage or ontogenic development we compared immunoglobulin (Ig) heavy chain variable region (VH) gene usage and IgVH mutation status in 327 cases of CLL from 214 families, with 724 sporadic cases. The frequency of mutated CLL was higher in familial CLL (P<0.001) and there was evidence of intra-familial concordance in mutation status (P<0.001). The repertoire and frequency of IgVH usage was, however, not significantly different between familial and sporadic CLL. Furthermore, IgVH usage was not correlated between affected members of the same family. These observations provide evidence that familial CLL is essentially indistinguishable from sporadic CLL favoring a genetic basis to disease development in general rather than a simple environmental etiology.


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