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Biclonal Low-Grade B Cell Lymphoma as Detected by Multiparametric Flow Cytometry in Blood and Marrow

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Abstract

Background

Biclonal B cell lymphomas (BCL) of two different low-grade components are rare. Multiparametric flow cytometry (MFC) is an integral tool in lymphoma diagnosis and very efficient in picking up BCL cases, especially when the associated second component is small. We studied the incidence of BCL in the routine blood and marrow samples sent for immunophenotyping by MFC. A total of 376 cases were analyzed retrospectively. We studied their clinical, immunophenotypic, molecular, and cytogenetic findings with literature review. We found five cases of BCL with two different clonal low-grade B cell components at an incidence of 1.3%. All cases were males with a median age of 68 years. The chronic lymphocytic leukemia (CLL) clone was present in all 5 cases. The other associated component in cases 1 to 5 were lymphoplasmacytic lymphoma, follicular lymphoma, splenic marginal zone lymphoma, hairy cell leukemia, and monoclonal B cell population of non-CLL type respectively. Diagnosing BCL may be challenging and may also go undiagnosed when the second component is petite and overshadowed by the more significant component. It may be critical if the small, unnoticed lymphoma component is of a more aggressive type.

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Data Availability

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary material.

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Acknowledgements

We would like to acknowledge Dr Arun Kumar Arunachalam, Assistant professor, Christian medical college, Vellore and Dr Karthik Bomannan, Associate professor, Cancer institute (WIA), Chennai for reviewing the paper. We would also like to acknowledge Mr. Ellappan, and Mr Selvaraj, flow cytometry technologists, Department of Hematology for their efforts in sample processing, acquisition and data retrieval.

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The author(s) reported there is no funding associated with the work featured in this article.

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Authors and Affiliations

  1. Department of Hematology, Apollo Cancer Centre, Chennai, India

    Thulasi Raman Ramalingam, Srikanth Muralikrishnan, Jose Easow & Lakshman Vaidhyanathan

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  1. Thulasi Raman Ramalingam
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  2. Srikanth Muralikrishnan
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  3. Jose Easow
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  4. Lakshman Vaidhyanathan
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Correspondence to Thulasi Raman Ramalingam.

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Ramalingam, T.R., Muralikrishnan, S., Easow, J. et al. Biclonal Low-Grade B Cell Lymphoma as Detected by Multiparametric Flow Cytometry in Blood and Marrow. Indian J Hematol Blood Transfus 39, 691–698 (2023). https://doi.org/10.1007/s12288-022-01625-y

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  • DOI: https://doi.org/10.1007/s12288-022-01625-y

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