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Prospective study of prognostic factors in asymptomatic patients with B-cell chronic lymphocytic leukemia-like lymphocytosis: the cut-off of 11 × 109/L monoclonal lymphocytes better identifies subgroups with different outcomes

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Abstract

The arbitrary threshold of 5 × 109/L chronic lymphocytic leukemia (CLL)-like lymphocytes differentiates monoclonal B lymphocytosis (MBL) from CLL. There are no prospective studies that search for the optimal cut-off of monoclonal lymphocytes able to predict outcome and simultaneously analyze the prognostic value of classic, immunophenotypic, and cytogenetic variables in patients with asymptomatic clonal CLL lymphocytosis (ACL), which includes MBL plus Rai 0 CLL patients. From 2003 to 2010, 231 ACL patients were enrolled in this study. Patients with 11q deletion and atypical lymphocyte morphology at diagnosis had shorter progression-free survival (PFS) (p = 0.007 and p = 0.015, respectively) and treatment-free survival (TFS) (p = 0.009 and p = 0.017, respectively). Elevated beta-2 microglobulin (B2M) also correlated with worse TFS (p = 0.002). The optimal threshold of monoclonal lymphocytes independently correlated with survival was 11 × 109/L (p = 0.000 for PFS and p = 0.016 for TFS). As conclusion, monoclonal lymphocytosis higher than 11 × 109/L better identifies two subgroups of patients with different outcomes than the standard cut-off value of 5 × 109/L. Atypical lymphocyte morphology, 11q deletion and elevated B2M had a negative impact on the survival in ACL patients.

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Acknowledgments

This study was supported by “Instituto de Salud Carlos III” (RTICC RD12/0036/0029).

Conflict of interest

The authors have no conflicts of interest to declare.

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No funding was received for this study.

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Authors and Affiliations

  1. Department of Clinical Hematology, Institut Català d’Oncologia, Hospital Duran i Reynals, IDIBELL, Gran Vía 199-203, Hospitalet, 08908, Barcelona, Spain

    A. C. Oliveira, A. Fernández de Sevilla, E. Domingo-Domènech, S. Mercadal & E. González-Barca

  2. Department of Hematology, Hospital de Bellvitge, IDIBELL, Hospitalet, Barcelona, Spain

    A. Domingo, E. De La Banda & E. Alonso

  3. Department of Hematology, Institut Català d’Oncologia, Hospital Universitari Germans Trias i Pujol, IJC, Badalona, Barcelona, Spain

    N. Ruiz-Xivillé

  4. Clinical Investigation Unit, Institut Català d’Oncologia, Hospital Duran i Reynals, IDIBELL, Hospitalet, Barcelona, Spain

    M. Encuentra

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  1. A. C. Oliveira
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  2. A. Fernández de Sevilla
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  3. A. Domingo
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  4. E. De La Banda
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  5. E. Domingo-Domènech
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  6. S. Mercadal
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  7. N. Ruiz-Xivillé
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  8. E. Alonso
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  10. E. González-Barca
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Correspondence to A. C. Oliveira.

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Oliveira, A.C., Fernández de Sevilla, A., Domingo, A. et al. Prospective study of prognostic factors in asymptomatic patients with B-cell chronic lymphocytic leukemia-like lymphocytosis: the cut-off of 11 × 109/L monoclonal lymphocytes better identifies subgroups with different outcomes. Ann Hematol 94, 627–632 (2015). https://doi.org/10.1007/s00277-014-2263-1

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  • DOI: https://doi.org/10.1007/s00277-014-2263-1

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