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The biological and clinical relationship between CD5 + 23 + monoclonal B‐cell lymphocytosis and chronic lymphocytic leukaemia
Author(s) -
Rawstron Andy C.,
Bennett Fiona,
Hillmen Peter
Publication year - 2007
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2007.06863.x
Subject(s) - lymphocytosis , cd5 , chronic lymphocytic leukemia , immunology , monoclonal , population , biology , monoclonal antibody , phenotype , medicine , antibody , leukemia , genetics , gene , environmental health
Summary A CD5 + 23 + monoclonal B‐cell population is detectable in approximately 3% of the general adult population. The phenotype of the monoclonal CD5 + 23 + B cells is identical to chronic lymphocytic leukaemia (CLL) with respect to a large number of proteins in addition to the standard diagnostic markers used to identify CLL. Studies in CLL families and direct assessment of genetic features indicate a close biological association between indolent CLL and the CLL‐phenotype cells detected in individuals with a normal blood count. Patients with a CLL‐phenotype monoclonal B‐cell lymphocytosis (MBL) often have increasing CLL cell counts with time and some progress to a stage requiring treatment. Analysis of intraclonal variation in the immunoglobulin heavy chain gene suggests a process of clonal diversification rather than clonal selection in the early stages of disease progression. CLL‐phenotype MBL is detectable in approximately 10% of cases referred for investigation of a lymphocytosis and future studies should be directed towards the detection of factors which identify MBL patients at risk of disease progression.