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Hospital population screening reveals overrepresentation of CD5− monoclonal B-cell lymphocytosis and monoclonal gammopathy of undetermined significance of IgM type

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Abstract

Monoclonal B-cell lymphocytosis (MBL) and monoclonal gammopathy of undetermined significance (MGUS) result from clonal expansions of mature B or plasma cells. Here, we set out to determine the immunophenotypic/monoclonal immunoglobulin (M protein) features and co-prevalence of MBL and MGUS in a hospital-based cohort of 1909 non-hematooncological patients. Of the evaluable cases, 3.8 % showed evidence for MBL by immunophenotyping, while 9.8 % were screened positive for M protein by immunofixation. With six concomitant cases (0.4 %), MBL and MGUS were not statistically associated. At least in two of these coincident cases, MBL and MGUS were of different clonal origin since both clones had divergent light chain restriction. CD5− MBL (57.1 %) and IgM+ MGUS (24.7 %) were strikingly overrepresented compared to population-based screenings and did not progress to overt lymphoma or myeloma during the observation period (mean follow-up of 117 weeks or 110 weeks, respectively). Prevalence and phenotypes suggest that a substantial proportion of incidental MBL and MGUS in hospitalized patients may be attributed to transiently expanded B-cell clones in the context of disease-related immune stimulation rather than reflecting veritable precursors of clonal B-cell malignancies.

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Acknowledgments

All authors gave final approval for the manuscript to be published.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Department of Oncology and Hematology, Hubertus Wald Tumorzentrum/UCCH, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Minna Voigtlaender, Birthe Vogler, Carsten Bokemeyer & Mascha Binder

  2. Department of Anaesthesiology and Intensive Care, Sana Klinikum Elmshorn, Elmshorn, Germany

    Birthe Vogler

  3. Department of Internal Medicine II, Oncology and Hematology, Central Hospital of Augsburg, Augsburg, Germany

    Martin Trepel

  4. Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, University Hospital RWTH Aachen, RWTH Aachen University Medicine, Aachen, Germany

    Jens Panse

  5. Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Roman Jung

  6. Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany

    Ulrike Bacher

Authors
  1. Minna Voigtlaender
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  2. Birthe Vogler
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  3. Martin Trepel
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  4. Jens Panse
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  5. Roman Jung
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  6. Carsten Bokemeyer
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  7. Ulrike Bacher
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  8. Mascha Binder
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Correspondence to Mascha Binder.

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Voigtlaender, M., Vogler, B., Trepel, M. et al. Hospital population screening reveals overrepresentation of CD5− monoclonal B-cell lymphocytosis and monoclonal gammopathy of undetermined significance of IgM type. Ann Hematol 94, 1559–1565 (2015). https://doi.org/10.1007/s00277-015-2409-9

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  • DOI: https://doi.org/10.1007/s00277-015-2409-9

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