B-Cell Clones Often Present Before Leukemia Diagnosis

-- Eric Metcalf

Wednesday, February 11, 2009

WEDNESDAY, Feb. 11 (HealthDay News) -- Nearly all cases of chronic lymphocytic leukemia are preceded by monoclonal B-cell lymphocytosis, which affects roughly 4 percent of individuals over the age of 50, according to research published in the Feb. 12 issue of the New England Journal of Medicine.

Ola Landgren, M.D., Ph.D., of the National Cancer Institute in Bethesda, Md., and colleagues analyzed data from 77,469 healthy adults enrolled in the screening group of a cancer screening trial. Forty-five individuals who had an available pre-diagnostic whole blood sample were diagnosed with chronic lymphocytic leukemia roughly three years after the sample was obtained.

Forty-four of the patients (98 percent) showed evidence of pre-diagnostic monoclonality among B cells on flow cytometry or molecular analysis, the researchers report. The investigators were able to analyze the immunoglobulin heavy-chain variable (IGHV) genes in 35 of the patients, and found that 27 (77 percent) of the IGHV sequences had mutations.

"This report is a timely addition to our knowledge of circulating monoclonal B cells in people without apparent hematologic disease, a condition now termed monoclonal B-cell lymphocytosis (MBL)," write the authors of an accompanying editorial. "A better understanding of MBL and monoclonal gammopathy of undetermined significance through prospective studies like the one by Landgren et al. should open new doors to the detection, assessment, treatment and prevention of B-cell lymphoid cancers."

Two of the study co-authors are employees of Quest Diagnostics.

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