Annals of Hematology

, Volume 95, Issue 10, pp 1695–1704 | Cite as

Detection of non-CLL-like monoclonal B cell lymphocytosis increases dramatically in the very elderly, while detection of CLL-like populations varies by race: findings in a multiethnic population-based cohort of elderly women

  • Kerstin L. EdlefsenEmail author
  • Sindhu Cherian
  • Anneclaire J. De Roos
  • Asqual Getaneh
  • Lawrence Lessin
  • Wenjun Li
  • Brent L. Wood
  • Alexander P. Reiner
Original Article


Monoclonal B cell lymphocytosis (MBL) is both a marker of immune senescence and a potential precursor of B cell malignancy. Most MBL populations have a chronic lymphocytic leukemia-like (CLL-like) immunophenotype, but those that are CD5-negative (non-CLL-like) are also recognized and may represent a distinct diagnostic entity. To date, MBL studies have taken place in relatively homogenous populations, although risk of CLL varies across racial groups and geographic regions. We report flow cytometry data from 597 ethnically diverse 64–94-year-old women from across the USA who are participants in the Women’s Health Initiative (WHI) Long-Life Study (LLS). Overall, MBL was detected in 26 % of the participants and included 20.9 % with a CLL-like immunophenotype, 5 % with a non-CLL-like immunophenotype, and 1.3 % with both. White and Hispanic women were more than twice as likely to have a CLL-like MBL population detected than African American women, corrected for age (P = 0.003). By contrast, detection of non-CLL-like MBL did not vary significantly by race, but did increase markedly with advancing age, being present in 12.7 % of those aged 85 and older. We provide new evidence that rates of detection of CLL-like MBL are lower in African Americans, and further suggest that non-CLL-like clonal expansions should be regarded as distinct from CLL-like MBL.


Monoclonal B cell lymphocytosis (MBL) Race Elderly Women Chronic lymphocytic leukemia (CLL) 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Financial support

The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C.

Potential conflicts of interest and disclosures

The authors have no potential conflicts of interest to declare. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Supplementary material

277_2016_2760_MOESM1_ESM.doc (62 kb)
ESM 1 (DOC 62 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Kerstin L. Edlefsen
    • 1
    Email author
  • Sindhu Cherian
    • 1
  • Anneclaire J. De Roos
    • 2
  • Asqual Getaneh
    • 3
  • Lawrence Lessin
    • 4
  • Wenjun Li
    • 5
  • Brent L. Wood
    • 1
  • Alexander P. Reiner
    • 6
    • 7
  1. 1.Department of Laboratory MedicineUniversity of Washington Medical CenterSeattleUSA
  2. 2.Department of Environmental and Occupational HealthDrexel University School of Public HealthPhiladelphiaUSA
  3. 3.MedStar Health Research InstituteHyattsvilleUSA
  4. 4.Washington Cancer Institute at Medstar Washington Hospital CenterWashingtonUSA
  5. 5.Department of MedicineUniversity of Massachusetts Medical SchoolWorcesterUK
  6. 6.Department of EpidemiologySchool of Public Health, University of WashingtonSeattleUSA
  7. 7.Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleUSA

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