Clinical progression and outcome of patients with monoclonal B-cell lymphocytosis
Clinical progression and outcome of patients with monoclonal B-cell lymphocytosis
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DOI：
10.1080/10428190701321277
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发表时间：
2007-01-01
影响因子：
2.6
通讯作者：
Leitch, Heather A.
中科院分区：
文献类型：
--
作者：
Fung, Sarah S.;Hillier, Kortney L.;Leitch, Heather A.
单克隆B细胞淋巴细胞增多症（MBL）是一种克隆性淋巴细胞增生，具有慢性淋巴细胞白血病（CLL）的免疫表型，但B淋巴细胞计数低于5 × 10（9）/l，无淋巴结病、器官肿大、血细胞减少或症状。我们对MBL（n = 46）、Rai 0期CLL（n = 112）和Rai ≥ 1期CLL（n = 54）患者进行了回顾性分析。中位随访时间和范围为：MBL为30（0.1 - 120）个月，0期CLL为60（0.1 - 309）个月，>= 1期CLL为54（0.1 - 309）个月.与112名0期CLL患者中的24名（21%）和54名>= 1期CLL患者中的28名（52%）相比，没有MBL患者需要治疗（p < 00.0003）。与112例0期CLL患者中的1例（0.8%）和54例≥ 1期CLL患者中的6例（11%）相比，没有MBL发生侵袭性转化（p < 00.0003）。与0期CLL相比，MBL的无进展生存期（PFS）似乎有所改善，尽管由于MBL组的随访时间相对较短，这并未达到统计学显著性（p = 0.07）;两年PFS对于MBL为97.2%，对于0期CLL为93.1%，对于>= 1期CLL患者为68%（p < 00.0001 for stage >= 1 CLL与MBL和0期CLL相比）。这是第一项关于MBL结局的研究，表明与0期CLL患者相比，患者的病程有所改善。在中位2.5年的随访中，没有MBL患者需要治疗或死于CLL相关原因。
Monoclonal B- cell lymphocytosis (MBL) is a clonal lymphoproliferation with the immunophenotype of chronic lymphocytic leukemia (CLL) but a B-lymphocyte count of less than 5 x 10 (9)/l and no lymphadenopathy, organomegaly, cytopenias or symptoms. We performed a retrospective analysis of patients with MBL (n = 46), Rai stage 0 CLL (n = 112) and Rai stage >= 1 CLL (n = 54). Median follow- up and range was 30 (0.1 - 120) months for MBL, 60 (0.1 - 309) months for stage 0 CLL and 54 (0.1 - 309) months for stage >= 1 CLL. None of the MBL patients required treatment compared with 24 of 112 (21%) stage 0 CLL and 28 of 54 (52%) stage >= 1 CLL patients (p < 00.0003). No MBL underwent aggressive transformation compared with 1 of 112 (0.8%) stage 0 CLL and 6 of 54 (11%) stage >= 1 CLL patients (p < 00.0003). Progression-free survival (PFS) appeared improved in MBL compared to stage 0 CLL, although this did not reach statistical significant (p = 0.07) due to the relatively short follow- up in the MBL group; two year PFS was 97.2% for MBL, 93.1% for stage 0 CLL, and 68% for stage >= 1 CLL patients (p < 00.0001 for stage >= 1 CLL compared with MBL and stage 0 CLL). This is the first study of outcome in MBL which demonstrates that patients have an improved disease course compared to stage 0 CLL patients. Over a median 2.5 years of follow- up, no MBL patients required treatment or died of CLL-related causes.